Comparison between early gall bladdercancer and advanced gall bladdercancer in terms of clinicopathologic factors: large volume tertiary center experience

Background:Early diagnosis of gallbladder cancer (GBC) which enables to surgical resection is key for improve prognosis. Aim of this study was to investigate clinical features of early GBC patients compare to advanced ones.Methods:We retrospectively reviewed medical records of all pathologically confirmed primary GBC patients between in single tertiary referral center.Results:250 patients (57.3%) were early GBC (stage IandII) and 186 (42.7%) were advanced GBC (stage IIIandIV). Less patients with early GBC had symptom at initial diagnosis (69.2% versus90.8%, p<0.001). Large number of patients with early GBC were diagnosed GBC incidentally after surgical resection which initially suspected benign gallbladder polyp or symptomatic gallbladder stones (71/250, 28.4% versus7/186, 3.8%) (p<0.001). Patients who initially diagnosed gallbladder stone or cholecystitis tended to more advanced than gallbladder polyp.Conclusions:There were no definitive symptoms which can detect early GBCs. Large number of early GBCs were diagnosed incidentally and many of these initially diagnosed with or accompany with benign cholecystic disease. Careful examination should be performed before diagnosis and after treatment, even in patient with vague symptom or benign cholecystic disease without elevated tumor markers.

Photoacoustic Imaging for Differential Diagnosis of Benign Polyps versus Malignant Polyps of the Gallbladder: A Preliminary Study

OBJECTIVE: To investigate the feasibility of ex vivo multispectral photoacoustic (PA) imaging in differentiating cholesterol versus neoplastic polyps, and benign versus malignant polyps, of the gallbladder. MATERIALS AND METHODS: A total of 38 surgically confirmed gallbladder polyps (24 cholesterol polyps, 4 adenomas, and 10 adenocarcinomas) from 38 patients were prospectively included in this study. The surgical specimens were set on a gel pad immersed in a saline-filled container. The PA intensities of polyps were then measured, using two separate wavelength intervals (421–647 nm and 692–917 nm). Mann-Whitney U test was performed for the comparison of normalized PA intensities between the cholesterol and neoplastic polyps, and between the benign and malignant polyps. Kruskal-Wallis test was conducted for the comparison of normalized PA intensities among the cholesterol polyps, adenomas, and adenocarcinomas. RESULTS: A significant difference was observed in the normalized PA intensities between the cholesterol and neoplastic polyps at 459 nm (median, 1.00 vs. 0.73; p = 0.032). Comparing the benign and malignant polyps, there were significant differences in the normalized PA intensities at 765 nm (median, 0.67 vs. 0.78; p = 0.013), 787 nm (median, 0.65 vs. 0.77; p = 0.034), and 853 nm (median, 0.59 vs. 0.85; p = 0.028). The comparison of the normalized PA intensities among cholesterol polyps, adenomas, and adenocarcinomas demonstrated marginally significant differences at 765 nm (median, 0.67 vs. 0.66 vs. 0.78, respectively; p = 0.049). CONCLUSION: These preliminary results indicate that benign versus malignant gallbladder polyps might exhibit different spectral patterns on multispectral PA imaging.

The correlation of contrast-enhanced ultrasound vascular mode with gallbladder polyp nature and size / 中华医学超声杂志（电子版）

Objective To evaluate the correlation between enhancement vascular mode and gallbladder polyp nature and size with contrast-enhance ultrasound (CEUS).Methods From December 2014 to May 2016,patients with gallbladder polyp lesions (GPL) larger than 1.0 cm were enrolled in this study.Before cholecystectomy,every patient underwent ultrasound (US) and CEUS examination.All features of US and CEUS were analyzed by two doctors who were blind to the patient clinical data.According to the pathological findings,GPL were divided into cholesterol polyp group and gallbladder adenoma group.The US features and enhancement vascular mode were analyzed statistically by t test and x2 test.The independent risk factors were analyzed by Logistic regression.The relationship between enhancement vascular mod and size of GPL were determined by bivariate correlation analysis.Results There were 103 patients with GPL larger than 1.0 cm.Eighty-two cases were cholesterol polyp and 21 cases were gallbladder adenoma.There were differences in size and color Doppler blood flow between two groups (t=-5.97 and 7.94,P ＜ 0.05).Dotted,branched vascular mod and irregular vascular mode were statistical different between two groups (x2=10.09 and 8.43,P ＜ 0.05).Regression analysis data proved that the size and branch vascular mod were the independent risk factors related with adenoma (P ＜ 0.05).In both cholesterol polyp group and adenoma group,there were weak positive correlation between enhancement vascular mode and size of GPL (r=0.188,0.397,P ＜ 0.05).Conclusions Branch vascular mod and size of GPL were help to distinguish gallbladder adenoma from cholesterol polyp.Comprehensive analysis of GPL's size and vascular mode could offer important guidance for differentiation diagnosis.

Correlación entre diagnóstico ecográfico e histopatológico de poliposis vesicular en la Clínica Good Hope 2008-2014 / Correlation between sonographic diagnosis and histopathological results of gallbladder poliposis in Good Hope Clinic 2008-2014

Objetivo: determinar la correlación entre el diagnóstico ecográfico y el resultado histopatológico de poliposis vesicularen los pacientes y encontrar el valor predictivo positivo de la ecografía en el diagnóstico de esta patología.Material y Métodos: Es una investigación no experimental, transversal, descriptiva y correlacional, realizada en unamuestra de 128 pacientes operados con diagnóstico de poliposis vesicular en la clínica Good Hope entre 2008 y 2014. Serevisaron los informes ecográficos e histopatológicos de estos pacientes y se buscó la relación mediante el coeficiente decorrelación de Spearman.Resultados: El 67,2% de la muestra correspondió al sexo femenino y el 32,8% al sexo masculino; la edad promedio fue de43,4 años. El 74,2% de los 128 casos presentó pólipos según el examen histopatológico, de los cuales el 94,7% fueronpseudopólipos y 84% fueron pólipos de colesterol; solo el 5,3% de los pólipos fueron verdaderos (adenomas) y ninguno deellos fue maligno, el pólipo más grande midió 13 mm. El valor predictivo positivo de la ecografía en el diagnóstico depoliposis vesicular fue 74.21%. La correlación entre el número de pólipos por ecografía e histopatología según elcoeficiente de Spearman fue muy baja, directa y significativa (Rho=0,189, p=0,032).Conclusión: Existe una correlación directa entre el diagnóstico ecográfico y el resultado histopatológico de poliposisvesicular; la ecografía puede considerarse como un método confiable para el diagnóstico de esta patología.

Objective: To determine the correlation between sonographic diagnosis and histopathological results of gallbladderpolyposis and find the positive predictive value of ultrasound in the diagnosis of this pathology.Material and Methods: It is a non experimental, transversal, descriptive and correlational study with a sample composedof all patients operated with a diagnosis of gallbladder polyps in the Good Hope Clinic between the years 2008 and 2014. Atotal of 128 patients were observed. Histopathological and sonographic reports of these patients were reviewed and thestatistical correlation of both studies was sought by the test of Spearman.Results: Reveals that 67,2% were females and 32,8% were males; the average age was 43,4 years; 74,2% presented polypsby histopathological examination, of which 94,7% were pseudopolyps, with 82 % cases of cholesterolpolyps, only 5,3% weretrue polyps (adenomas) and none of them were malignant. The positive predictive value of ultrasound in the diagnosis ofgallbladder polyposis was 74,21%. According to the Spearman coefficient the correlation between the number of polyps byultrasonography and histopathology was low, direct and significant (Rho = 0,189; p = 0,032).Conclusions: We conclude that there is a correlation between the ultrasound diagnosis and histopathological result ofgallbladder polyps and ultrasound can be considered a reliable method for the diagnosis of gallbladder polyps.

Visceral Obesity If Associated with Gallbladder Polyps

BACKGROUND/AIMS: Gallbladder polyps (GBP) are a common clinical finding and may possess malignant potential. We conducted this study to determine whether visceral obesity is a risk factor for GBP. METHODS: We retrospectively reviewed records of subjects who received both ultrasonography and computed tomography with measurements of the areas of visceral adipose tissue and total adipose tissue (TAT) on the same day as health checkups. RESULTS: Ninety-three of 1,615 subjects (5.8%) had GBP and were compared with 186 age- and sex-matched controls. VAT (odds ratio [OR], 2.941; 95% confidence interval [CI], 1.325 to 6.529; p=0.008 for the highest quartile vs the lowest quartile) and TAT (OR, 3.568; 95% CI, 1.625 to 7.833; p=0.002 for the highest quartile vs the lowest quartile) were independent risk factors together with hypertension (OR, 2.512; 95% CI, 1.381 to 4.569; p=0.003), diabetes mellitus (OR, 2.942; 95% CI, 1.061 to 8.158; p=0.038), hepatitis B virus positivity (OR, 3.548; 95% CI, 1.295 to 9.716; p=0.014), and a higher level of total cholesterol (OR, 2.232; 95% CI, 1.043 to 4.778; p=0.039 for or =240 mg/dL). Body mass index and waist circumference were not meaningful variables. CONCLUSIONS: Visceral obesity measured by VAT and TAT was associated with GBP irrespective of body mass index or waist circumference.

Is the Prevalence of Gallbladder Polyp Different between Vegetarians and General Population? / 대한소화기학회지

BACKGROUND/AIMS: Gallbladder polyps (GBP) are a common clinical finding that can express malignant potential. The aim of this study was to evaluate whether vegetarianism protects against GBP, together with other putative risk factors. METHODS: A retrospective, cross-sectional study was conducted with subjects who received a health check-up from July 2005 to December 2011. Korean Buddhist priests, who are obligatory vegetarians by religious belief, were identified as vegetarians (vegetarian group) and compared with a non-vegetarian control group sampled from those coming for health check-ups at the same institution. RESULTS: Out of 18,483 subjects, GBP were found in 810 (4.4%). Although GBP tended to be less common in the vegetarian group (23 [3.5%] out of 666) than in control group (787 [4.4%] out of 17,817), the difference was insignificant statistically (p=0.233). By logistic regression, old age (OR=1.61, 95% CI=1.19-2.26 for 30-39 years; OR=1.47, 95% CI=1.08-1.98 for 40-49 years), male gender (OR=1.51, 95% CI=1.31-1.75), high BMI (OR=1.18, 95% CI=1.00-1.39 for > or =23.0 kg/m2 and <25.0 kg/m2) and HBsAg positivity (OR=1.53, 95% CI=1.19-1.98) were independent risk factors of GBP. CONCLUSIONS: GBP was significantly associated with old age, male gender, high BMI and HBsAg positivity, but not with vegetarianism.

Association of Gallbladder Polyp with the Risk of Colorectal Adenoma

BACKGROUND/AIMS: Gallbladder polyps and colorectal adenomas share many common risk factors; however, their association has never been studied. The aim of this study was to investigate this association in asymptomatic healthy subjects. METHODS: Consecutive asymptomatic subjects who underwent both screening colonoscopy and abdominal ultrasonography at Kyung Hee University Hospital in Gang Dong between July 2010 and April 2011 were prospectively enrolled. The prevalence of colorectal adenoma was compared between subjects with or without gallbladder polyps. Furthermore, a logistic regression analysis was performed to determine the independent risk factors for colorectal adenoma in these subjects. RESULTS: Of the 581 participants, 55 presented with gallbladder polyps and 526 did not have gallbladder polyps. Participants with gallbladder polyps showed a trend toward a higher prevalence of colorectal adenoma than those without gallbladder polyps (52.7% vs. 39.2%, P=0.051). Although the result was not statistically significant, gallbladder polyps were found to be a possible risk factor for colorectal adenoma (odds ratio=1.796, 95% confidence interval=0.986-3.269, P=0.055), even after adjusting for potential confounding factors. There was no difference observed in colorectal adenoma characteristics between the two groups. CONCLUSIONS: Our results suggest a possible association between gallbladder polyps and colorectal adenomas. Future studies with larger cohorts are warranted to further investigate this matter.

A survey of attitudes to clinical practice guidelines in general and adherence of the Korea practical guidelines for management of gallbladder polyp: a survey among private clinicians in Korea

BACKGROUNDS/AIMS: While clinical practice guidelines are effective tools for improving the quality of patient care and provide specific recommendations for daily practice, the usage of them have been often suboptimal. Therefore, evaluation of physician attitude to guidelines is an important initial step in improving guideline adherence levels. The aim of this study was to survey the attitude on general guidelines and adherence with the Korea Practical Guidelines for gallbladder (GB) polyp two year after their publication and distribution among Korean private clinicians. METHODS: To evaluate the survey, questionnaires were sent with a stamp on an addressed envelope to 3,256 private clinicians who were registered at the Seoul Medical Association in April, 2010. From the 3,256 questionnaires, 376 clinicians (11.5%) responded to the survey. RESULTS: A total of 91.0% responders agreed to the statement that general guidelines were useful tools for improving patient care and quality of care. One hundred one responders (26.9%) stated that they were aware of the Korea GB polyp guidelines while 73 physicians (72.3%) founded the guideline had changed their practice and user-friendly. Most of physicians (73.4%) agreed to practical procedures recommended by guidelines. CONCLUSIONS: Korean primary physicians were generally positive to the practical guidelines, as propagation of the guideline among primary physicians may improve adherence to guideline and patients care for GB polyps.

Prevalence of Gallbladder Polyp in Adults in Korea / 가정의학회지

BACKGROUND: Incidentally discovered gallbladder polyp in a health check-up has been increasing in numbers due to the extended use of ultrasonography. Past research has reported on the relationship between body mass index and gallbladder (GB) polyp. As there has been a recent rise in the prevalence of obesity, this research attempted to study GB polyp prevalence and the trend according to time elapse in Korea. METHODS: Retrospective cross sectional research was carried out from the data of Korean Association of Health Promotion, between January 2, 2003 to August 3, 2007 in the subjects who received abdominal ultrasonography. The subjectrs excluded were those below 20 years of age, non-Asian and those who have received cholecystectomy. The number of eligible subjects were 137,135, where 69,493 were males and 67,642 were females. RESULTS: Out of 137,135 subjects, the number of subjects with GB polyp were 5,278, where 3,163 were males and 2,115 were females. According to 2005 census, the age adjusted prevalence was 3.7% (3,656 per 100,000). The prevalence for males was 4,403 per 100,000 (4.4%) and for females 2,943 per 100,000 (2.9%). The prevalence has been increasing for the past five years. CONCLUSION: The prevalence of GB polyp in Korea was found to be higher than the pre-existing reports and the prevalence was higher in males than females. The prevalence is on the increase and there is a need to be more attentive to this issue in the future.

15 Years of Experience in Laparoscopic Cholecystectomy by a Single Surgeon

PURPOSE: A laparoscopic cholecystectomy is the treatment of choice for gallbladder disease. The aim of this study is to analyse 2,239 cases of laparoscopic cholecystectomy (LC) and observe the changes of 15th-year gallbladder disease. METHODS: We performed a retrospective analysis of 2,239 patients that underwent a LC by a single surgeon, from March 1993 to December 2007. We divided it into 3 groups; group 1 was from March 1993 to December 1996 and group 2 was from January 1998 to December to 2001, group 3 was from January 2003 to December 2007. RESULTS: The mean age, hospital stay, mean operation time and conversion rate was decreased. Gallbladder cancer of group 1 was 0.6%, group 2 was 0.5%, and group 3 was 1.6% (P<0.05). Gallbladder polyps of group 1 was 3.3%, group 2 was 5.1%, and group 3 was 11.8%. There was statistically significance (P<0.05). Gallstone was significantly decreased (group 1 was 98.1%, group 2 was 97.6%, group 3 was 92.8%) in proportion, pigment stone was significantly decreased (group 1 was 31.5%, group 2 was 27.5%, group 3 was 21.7%) and Cholesterol & Mixed stone was significantly increased (group 1 was 68.2%, group 2 was 72.5%, group 3 was 78.3%)(P<0.05). CONCLUSION: As surgical experience increased with a rising number of cases, the conversion rate, complications, hospital stay and mean operation time was decreased. Pigment gallstone was decreased and cholesterol gallstone was increased owing to western diet, old age and fatness.

Natural Course and Treatment Strategy of Gallbladder Polyp / 대한소화기학회지

The polypoid lesions of gallbladder have explosively increased with enhanced feasibility of transabdominal ultrasonography. Most of small polyps less than 10 mm are benign and remain static for a long period. In small polyps, three to six month intervaled ultrasonography is warranted in the initial follow-up, but the duration of follow-up period is not clarified. The polypoid lesions larger than 10 mm show a quite different feature. They showed a remarkable risk of malignancy (34-88%) and should be treated by surgery. Furthermore, age more than 50 years and combined gallstone are important factors predicting malignancy in polypoid lesions of gallbladder. In addition, other factors including solitary polyp and the presence of symptoms are considered as risk factors. Laparoscopic cholecystectomy is a golden standard therapy for these polyps unless the suspicion of malignancy is high. The gallbladder polyps remain a problem of concern to both doctors and patient with the worry of malignancy. Thus, the comprehensive understanding of natural coruse of gallbladder polyp and risk factors of malignancy should be kept in mind.

Is Metabolic Syndrome One of the Risk Factors for Gallbladder Polyps Found by Ultrasonography during Health Screening?

BACKGROUND/AIMS: We conducted this study to identify the risk factors for finding gallbladder polyps (GBP) in Korean subjects during health screening, and to determine the nature of the association between the presence of metabolic syndrome (MS) and the development of GBP. METHODS: A total of 1,523 subjects were enrolled, comprising 264 with GBP (81 women and 183 men) and 1,259 controls (696 women and 563 men with normal GB). Body mass index (BMI), waist circumference (WC), blood pressure (BP), insulin, fasting blood sugar (FBS), lipids, liver enzymes, hepatitis B antigens (HBs Ag), and hepatitis C antibodies (HCV Ab) were measured. MS was considered to be present when three or more of the NCEP-ATPIII (National Cholesterol Education Program-Adult Treatment Panel III) criteria were satisfied. Insulin resistance was calculated by homeostasis model assessment of insulin resistance (HOMA-IR). Independent risk factors were analyzed by logistic regression analysis. RESULTS: Univariate analysis revealed that the risk factors for GBP were age, sex, WC, smoking history, BP, BMI, FBS, serum lipids, HOMA-IR score, and MS. Multivariate logistic regression analysis revealed that the risk factors for GBP were presence of MS (Odds Ratio (OR)=2.35, 95%Confidence Interval (CI)=1.53-3.60), being male (OR=2.34, 95%CI=1.72-3.18), HOMA-IR score>2.5 (OR=1.64, 95%CI=1.19-2.26), and higher WC (OR=1.4, 95%CI=1.05-1.88). MS was present in 20.8% and 5.9% of GBP patients and controls, respectively, and was the highest risk factor for GBP. CONCLUSIONS: MS, male, insulin resistance, and abdominal obesity are probably risk factors for GBP, with MS appearing to be strongly associated with GBP in Koreans.

A Case of Gall Bladder Polyp in Children / 대한소아소화기영양학회지

Polypoid tumors of the gallbladder are diagnosed very rarely in children; there are only 13 cases of childhood gallbladder polyps reported in the medical literature worldwide. Unlike those found in adults that consist mostly of cholesterol, polypoid tumors in children tend to have variable pathologic features. For pediatric patients, cholecystectomy is recommended either when the polyp is larger than 1 cm or when it causes significant symptoms. But close observation with serial abdominal sonography is sufficient in most asymptomatic pediatric patient. Recently, we experienced a 15-year-old boy with gallbladder polyps who presented with recent onset abdominal pain and nausea. A cholecystectomy using peritoneoscope was performed. The pathologic examination of the polyp revealed a tubular adenoma.

Polypoid Lesions of the Gallbladder; Report of 111 Cases with Surgical Reference to Operative Indication

PURPOSE: There is no definitive operative indications for treatment of Gallbladder (GB) polypoid lesions. The objective of this study was to determine the indications for surgical treatment of polypoid lesions of the gallbladder. METHODS: Surgically resected polypoid lesions of the gallbladders of 111 patients who were treated at the Department of Surgery, EulJi Medical College, from Jan. 1991 to Jun. 2000 were evaluated based on patient age & sex, histologic result, and size & shape of the polyp. RESULTS: Out of the 111 cases, benign polyps were found in 88 cases (79%) and malignant polyps in 23 cases (21%). In sessile polyps, the average diameter of the benign polyps was 8.1+/-9 mm, and that of the malignant polyps was 16.6+/-9 mm, while in pedunculated polyps, the average diameter of the benign polyps was 9.5+/-8 mm, and that of the malignant polyps was 27.0+/-22 mm. CONCLUSION: In conclusion, surgical treatment is recommended if a sessile polyp is more than 5 mm and a pedunculated polyp is more then 10 mm because, in these cases, the chance of malignancy cannot be excluded. Also, if there are any symptoms related with the GB, regardless of how large it is and whether GB stone exists or not, surgical treatment is desirable.

Primarily study on a value of two dimensional ultrasound in diagnosis of gallbladder polyp comparing with surgery and anatopathology

A retrospective study on 20 operated patients with gallbladder polyp and a prospective study on 2 patients with gallbladder polyp of which 10 patient operated were carried out. Results were compared with results of diagnostic ultrasound and histological tests in 30 operated patients. They have shown that the ultrasound sensitivity was 73.3%, 50% of polyps were cholesterol polyps. 9/11 cholesterol polyps were small, with diameter less than 5 mm.

Laparoscopic diagnosis of gallbladder polyp

A study on 29 patients was laparoscopic diagnosed as gallbladder polyp has shown that gallbladder monopolyp (27.6%) and gallbladder multipolyps (72.4%). Polyps diameter of 5 mm, 5-10 mm and more than 10 mm were 55.2%, 34.5% and 10.3%, respectively. Polyps in the gallbladder cervix, gallbladder stem and gallbladder basal were 31%, 55.2% and 13.8%. Polyps type of increased sound (58.6%), type less sound (34.5%) and reduced sound (6.9%). The pedicular polyp (41.4%) and nonpedicular polyp (58.6%).

Prevalence and risk factors of gallbladder polyps in health screening subjects / 대한내과학회지

BACKGROUND: Gallbladder (GB) polyps are now increasingly detected by ultrasonography. We investigated the prevalence and risk factors of GB polyps in health screening population. METHODS: An ultrasonographic study of GB polyps were conducted in 35,012 subjects who received a paid health screening examination at Samsung Medical Center. Controls, twice the subjects with GB polyp, were randomly selected from the cases with normal GB. The demographic characteristics and biochemical parameters were recorded. RESULTS: The overall prevalence of GB polyps was 2.94% (1,330/15,573). Among them, 3.63% were men, 2.09% were women. In both males and females, the prevalence was highest in their 40s. The diameter of GB polyps ranged from 2 mm to 20 mm (mean 4.5 mm). Most polyps (98.3%) were less than 10 mm in diameter. Of 1,030 subjects, 64% had a single polyp and 36% had multiple polyps. Multiple logistic regression, with reference group of body mass index (BMI, <22.5 kg/m2), showed odds ratio of 1.074 and 1.864 for BMI groups of 22.5-24.9 and 25 or more respectively. In contrast, other demographic characteristics and biochemical parameters, such as age, smoking, alcohol use, glucose, liver function tests, lipid profiles and HBsAg carriage were lack of any relation to GB polyps. CONCLUSIONS: GB polyps are not likely to be rare in Korean adults despite their low prevalence compared to other reports. The body mass index may be a risk factor for GB polyps.

Imaging feature of laparoscopic ultrasound of gallbladder polyps

30 patients diagnosed as gallbladder polyps by laparoscopic ultrasound of which 12 patients received operations have shown that the male/female was 1/1; the disease occurred most frequently in ages of 40-50. The gallbladder multipolyps occurred more frequently than gallbladder polyp and rate of pedicular polyps was higher than nonpedicular polyp. 36.8% of patients accompanying with other diseases such as gallbladder stone, cancer, hepatic angioma. The laparoscopic ultrasound was high precise technique for diagnosis of gallbladder polyp (11/12).

Gastric Heterotopia in the Gallbladder / 대한소화기내시경학회지

Heterotopia (of Ectopia) is defined as the occurrence of normal tissue in an abnormal location. Heterotopic gastric mucosa has been found throughout the length of the gastrointestinal tract from oral cavity to the rectum. Curiously, it is extremely rare in the gailbladder, but when it occurs, it tends to cause symptoms of acute cholecystitis in patients under 20 years of age, and chronic cholecystitis and gallstones in older patients. The heterotopic mucosa results in an intramural mass, a polyp or multiloculated gallbladder. A firm diagnosis of gastric heterotopia is based on the presence of fundic or pyrolic mucosa replete with parietal and chief cells. A clear distinction from intestinal rnetaplasia should be made, but at times may be difficult. Potential complications include mucosal ulceration, obstruction, and hemorrhage. Treatment is cholecystectomy. We report a case of gastric heterotopia in the gallbladder of a 35-year-old-man. Ultrasonography showed fatty change of liver with a 1.5 cm-sized polypoid lesion in the gallbladder. Endoscopic retrograde cholangiography showed a small filling defect, revealed by pooling of the dye in the center, in the body of gallbladder. Laparoscopic cholecystectomy was performed. A sessile polypoid leision with central umbilication was seen in the upper body of gallbladder, without gallstones. The microscopic finding of polypoid lesion consisted of gastric pyloric glands with parietal and chief cells. The surrounding mucosa revealed ordinary gallbladder epithelium without any metaplastic change. We report a case of this condition in which there was a separate loculus lined by gastric epithelium.