Gallbladder polyps detected by ultrasonographic mass screening: Cholecystectomy upon detection vs. upon polyp enlargement

Abstract

We investigated 2,152 patients with gallbladder polyps detected by ultrasonographic mass screening at our institution. Nine underwent cholecystectomy later, when polyps had enlarged. Seven others, most with larger polyps, underwent cholecystectomy shortly after polyp detection. Characteristics were compared between these 2 surgical groups. In patients with surgery upon enlargement, mean polyp diameter at the time of cholecystectomy was 12.9 mm and the mean polyp growth rate was 2.6 mm/year. Ultrasonographically, these polyps most often showed homogenous echo patterns resembling liver parenchyma. Pathological diagnoses were cholesterol polyps in 7; papillary hyperplasia in 1; and tubular adenoma in 1. In patients with surgery immediately upon detection, the mean polyp diameter was 13.1 mm. Ultrasonographically, these polyps often showed homogenous echo patterns that included small cystic structures. Pathological diagnoses included 5 cholesterol polyps, 1 inflammatory polyp, and 1 carcinoma in situ. The polyp diameter at detection in the immediate surgery group was significantly greater than that in the group with surgery upon enlargement. Single polyps were significantly more prevalent in immediate surgery patients than in the other group. Careful follow-up is required in patients monitored for polyp showing homogenous echo patterns resembling liver parenchyma, in which polyps are enlarged prior to surgery, considering that this group may include tubular adenoma or carcinoma in situ.