Reasonable cholecystectomy of gallbladder polyp – 10 years of experience

Abstract

Summary: Background and objective: Although the incidence of carcinoma is not high in gallbladder polyps, it is essential to diagnose gallbladder cancer at an early stage to achieve a good therapeutic outcome. Therefore, the aim of this study was to define the characteristics of gallbladder polyps to establish sound criteria for surgical indications. Methods: In the current study, data from 516 patients with gallbladder polyps who underwent cholecystectomy were reviewed to correlate clinical features with histopathologic findings and identify risk factors with receiver-operating characteristic curves (ROCs). Results: Among the 516 patients who underwent cholecystectomy, 24 patients (4.6%) had cancerous change. The cancer group was significantly older (65.5 years (median, range 35–85)) than the non-cancer group (42 years (median, range 23–82)) (p < 0.001). Among the cancer group, the preoperative polyp size on ultrasonography was significantly larger (14 mm (median, range 9–30)) than the polyps in the non-cancer group (10.4 mm (median, range 1.9–45)) (p < 0.001). Using the ROC curve and considering the sensitivity and specificity for predicting malignant polyps, 12 mm may be a reasonable cutoff for considering a malignant polyp. Conclusions: Gallbladder polyps with 10–11 mm in asymptomatic young patients (less than 50 years old) have low risk of malignancy, and therefore, a careful “wait and see with follow up by using ultrasonography strategy” might be more appropriate than immediate cholecystectomy. Keywords: Cholecystectomy, Gallbladder polyp, Receiver-operating characteristic curve