Polypoid lesions of the gallbladder:: Report of 100 cases with special reference to operative indications

Background. The nature of polypoid lesions of the gallbladder is difficult to define before operation, and surgical indications still remain controversial. The nim of this study was to identify characteristics of each type of polypoid lesion of the gallbladder and idications for surgery. Methods. Clinical data were retrospectively correlated with the histopathologic char characteristics of polypoid lesions in 100 patients who had cholecystectomy. Results. There were 74 benign polypoid lesions, including 39 cholesterol polyps, 20 adenomas, and 15 with adenomyomatous hyperplasia and 26 malignant polypoid lesions. Twenty-seven, percent of patients with benign polyps and 73 percent of patients with malignant polyps were over GO years of age. Polypoid lesions of the gallbladder, were diagnosed by preoperative ultrasonography in only 36 patients (36%). All types of polypoid lesions of the gallbladder whether benign or malignant, were frequently solitary and gallstones coexisted in the majority of patients with all polypoid lesions of the gallbladder except cholesterol polyps. The lesions were > 10 nm in 88% of the malignant polyps and in only 15% of the benign polyps. Conclusions. The risk factors for malignancy were file age of the patient ( > 60 years) the coexistence of gallstones, and the size of the polypoid lesions (>10 mm in diameter). In asymptomatic patients, cholecystectomy can be justified if there are risk factors for malignancy.