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. 2019 Jun;8(3):219-227.
doi: 10.21037/hbsn.2018.12.15.

Neoplastic polyps in gallbladder: a retrospective study to determine risk factors and treatment strategy for gallbladder polyps

Yongliang Sun  1 , Zhiying Yang  1 , Xu Lan  2 , Haidong Tan  1
Affiliations

Neoplastic polyps in gallbladder: a retrospective study to determine risk factors and treatment strategy for gallbladder polyps

Yongliang Sun et al. Hepatobiliary Surg Nutr. 2019 Jun.

Abstract

Background: Preoperative differentiation of malignant and premalignant gallbladder polyps (GBPs) from benign lesions is a key imperative to guide treatment decision-making. We aimed to characterize the various types of GBPs and sought to identify the risk factors for neoplastic polyps. Our findings may help optimize treatment strategy.

Methods: Retrospective analysis of 686 patients with post-cholecystectomy pathologically-proven GBPs between January 2003 and December 2016. The patients were classified into non-neoplastic polyp group, benign neoplastic polyp group, and adenoma canceration group. Clinical features, ultrasound findings, and results of laboratory investigations and histopathological examination were reviewed and compared between the groups.

Results: Out of 686 patients, 542 (79.0%) had non-neoplastic polyps, 134 (19.5%) had neoplastic polyps, and 10 (1.5%) had adenoma canceration. The mean age was 46.06±12.12 years; 383 (55.8%) patients were female. The median (25th percentile, 75th percentile) time between diagnosis and surgery in the cholesterol polyp group [24 (3.5, 60) months] was significantly longer than that in adenoma [12 (2, 60) months] and adenoma canceration [5 (0.475, 12) months] groups. The mean diameter was 1.14±0.61 cm (range, 0.5-8.4 cm). Three hundred twelve (45.5%) patients had solitary polyps and intralesional blood flow was observed in 41 (6.0%) patients. On univariate analysis, age >49.5 years, polyp size >1.15 cm, solitary polyp, intralesional blood flow, absence of symptoms, and lack of cholecystitis showed a significant association with adenoma. On multivariate analysis, polyp size (>1.15 cm), intralesional blood flow, and lack of cholecystitis were independent predictors of adenoma.

Conclusions: Polyp size >1.15 cm, intralesional blood flow, and lack of cholecystitis were predictors of neoplastic polyps. Malignant transformation of adenoma may occur over a relatively short time.

Keywords: Gallbladder polyp (GBP); adenoma; cholesterol; malignancy; predictive factors.

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Schematic illustration of the study population and the patient-selection criteria. GBP, gallbladder polyp.
Figure 2
Figure 2
Receiver-operator characteristic curve of age and size of the polypoid lesions of the gallbladder.
See this image and copyright information in PMC

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References

    1. Cairns V, Neal CP, Dennison AR, et al. Risk and Cost-effectiveness of Surveillance Followed by Cholecystectomy for Gallbladder Polyps. Arch Surg 2012;147:1078-83. 10.1001/archsurg.2012.1948 - DOI - PubMed
    1. Lin WR, Lin DY, Tai DI, et al. Prevalence of and risk factors for gallbladder polyps detected by ultrasonography among healthy Chinese: analysis of 34 669 cases. J Gastroenterol Hepatol 2008;23:965-9. 10.1111/j.1440-1746.2007.05071.x - DOI - PubMed
    1. Marangoni G, Hakeem A, Toogood GJ, et al. Treatment and surveillance of polypoid lesions of the gallbladder in the United Kingdom. HPB (Oxford) 2012;14:435-40. 10.1111/j.1477-2574.2012.00471.x - DOI - PMC - PubMed
    1. Xu Q, Tao LY, Wu Q, et al. Prevalences of and risk factors for biliary stones and gallbladder polyps in a large Chinese population. HPB (Oxford) 2012;14:373-81. 10.1111/j.1477-2574.2012.00457.x - DOI - PMC - PubMed
    1. Christensen AH, Ishak KG. Benign tumors and pseudotumors of the gallbladder. Report of 180 cases. Arch Pathol 1970;90:423-32. - PubMed