Nature of Medium Sized Gallbladder Polyps

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Published: Jun 1, 2018
Keywords:
Medium sized gallbladder polyps cholecystectomy adenomatous polyp

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Thada Yongpradit
Department of Surgery, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
Romyen Jitmungngan
Division of General surgery, Golden Jubilee Medical Center, Mahidol University, Salaya, Nakhon Pathom, Thailand

Abstract

Objective: This study aimed to trace and study the nature of medium sized gallbladder polyps for analysis and improving the guideline for screening and follow up the patients with gallbladder polyps in Golden Jubilee Medical Center.


Methods: Prospective descriptive study. All patients with medium sized gallbladder polyps (size more than 6 mm, but less than 10 mm) underwent follow up by ultrasound every 6 months for at least 2 years (February 2013 to February 2015). These patients will have an advice for cholecystectomy when meet indications including: symptoms, increasing in size of polyps or size of polyps equal or more than 10 mm, abnormality of gallbladder polyps from ultrasound, patient need. Main outcome measures: Prognosis of medium sized gallbladder polyps and Incidence of gallbladder cancer.


Results: There were total 35 cases of medium sized gallbladder polyps within 2 years follow up with female 21 cases (60%) and male 14 cases (40%). Diabetes mellitus (40%) and dyslipidemia (20%) were found as underlying diseases. Patients with age equal or more than 50 years old (89%) had gallbladder polyps more than patient with age below 50 years old. Twenty-seven cases (77%) of gallbladder polyps remained stable in size, but eight cases (23%) had average growth rate of gall bladder polyps at 0.05 mm per month. 9 mm. sized polyps had rapid growth 10 times more than smaller polyps. No incidence of gall bladder cancer in this study (just 1 patient with adenomatous polyp).


Conclusion: Medium sized gallbladder polyps remained asymptomatic if there was no associated gallstone. Female with age equal or more than 50 years old with diabetes mellitus and dyslipidemia tend to find a higher rate of gallbladder polyps. More than two third of medium sized polyps remained stable in size, but 9mm. sized polyps had rapid growth 10 times more than smaller polyps.

Article Details

How to Cite
Yongpradit, T., & Jitmungngan, R. (2018). Nature of Medium Sized Gallbladder Polyps. Vajira Medical Journal : Journal of Urban Medicine, 62(Supplement), S11–18. Retrieved from https://he02.tci-thaijo.org/index.php/VMED/article/view/209274
Issue
Vol. 62 No. Supplement (2018): June 2018
Section
Original Articles

References

1. Kwon W, Jang JY, Lee SE, Hwang DW, Kim SW. Clinicopathologic features of polypoid lesions of the gallbladder and risk factors of gallbladder cancer. J Korean Med Sci. 2009;24: 481-7.

2. Malene R, Claus D, Soren R. Ultrasound followup for gallbladder polyps less than 6 mm may not be necessary. Dan Med J. 2012;59(10):A4503.

3. Gallahan WC, Conway JD. Diagnosis and management of gallbladder polyps. Gastroenterol Clin North Am. 2010;39: 359–67.

4. Cha BH, Hwang JH, Lee SH, Kim JE, Cho JY, Kim H, et al. Pre-operative factors that can predict neoplastic polypoid lesions of the gallbladder. World J Gastroenterol. 2011 May 7;17(17): 2216-22.

5. Michael T, Bettina S, Robert G, Robert A. Incidentally Detected Gallbladder Polyps: Is Follow-up Necessary? — Long-term Clinical and US Analysis of 346 Patients. Radiology. 2011 Jan;258(1): 277-82.

6. Bang S. Natural course and treatment strategyof gallbladder polyp. Korean J Gastroenterol. 2009;53: 336-40.

7. Lee JS, Lee KT, Jung JH, Ok SW, Choi SC, Lee KH, et al. Factors Associated with Malignancy in Gallbladder Polyps without Gallbladder Stone. Korean J Gastroenterol. 2008;52: 97-105.

8. Matos AS, Baptista HN, Pinheiro C, Martinho F. Gallbladder polyps: how should they be treated and when. Rev Assoc Med Bras. 2010;56(3): 318-21.

9. Park JY, Hong SP, Kim JY, Kim HJ, Kim HM, Cho JH, et al. Long-term Follow Up of Gallbladder Polyps. J Gastroenterol Hepatol. 2009;24(2):219-22.

10. Randi G, Franceschi S, La Vecchia C. Gallbladder cancer worldwide: geographical distribution and risk factors. Int J Cancer. 2006 ;118(7):1591–602.

11. Park CH, Chung MJ, Oh TG, Park JY, Bang S, Park SW, et al. Differential diagnosis between gallbladder adenomas and cholesterol polyps on contrast-enhanced harmonic endoscopic ultrasonography. Surg Endosc. 2013 Apr;27(4):1414-21.

12. Covarrubias C, Merino G, Cruz F. Correlation between ultrasound and pathology of the gallbladder. Rev Med Chil. 1992;120: 1227-30.

13. Irie H, Kamochi N, Nojiri J, Egashira Y, Sasaguri K, Kudo S. High b-value diffusion-weighted MRI in differentiation between benign and malignant polypoid gallbladder lesions. Acta Radiol. 2011;52: 236-40.

14. Furukawa H, Kosuge T, Shimada K, Yamamoto J, Kanai Y, Mukai K. Small polypoid lesions of the gallbladder : differential diagnosis and surgical indications by helical computed tomography. Arch Surg. 1998;133: 735-9.

15. Ito H, Hann LE, D'Angelica M, Allen P, Fong Y, Dematteo RP, et al. Polypoid lesions of the gallbladder: diagnosis and follow up. J Am Coll Surg. 2009 Apr;208(4): 570-5.

16. Shin SR, Lee JK, Lee KH, Lee KT, Rhee JC, Jang KT, et al. Can the growth rate of a gallbladder polyp predict a neoplastic polyp? J Clin Gastroenterol. 2009 Oct;43(9): 865-8.