[Polypoid lesions of the gallbladder in Emam Reza hospital in Mashhad]

ABSTRACT

Polypoid lesions of the gallbladder encompass a wide variety of pathology. Although most of these lesions are benign, some early carcinoma of the gallbladder do present as polypoid lesions. Problems remain in selecting patients with polypoid lesions of the gallbladder for surgery. 411 patients underwent cholecystectomy for gallbladder disease in the department of surgery, Imam Reza hospital between 1995 and 2000. Benign polyps were present in 32 gallbladders and malignant polyps in 8 patients. Clinical data, age and sex distribution, symptoms and evaluation of preoperative diagnosis were correlated with the pathology of polyps were reviewed. In 411 patients undergoing cholecystectomy benign polyps were present in 32 gallbladder and malignant polyps in 8. Cholesterol polyps account for most of benign lesions and all malignant lesions were adenocarcinoma. Gallstone coexisted in 50% of malignant lesions. 69% of patients with benign lesions were under 60 years, whereas 75% of malignant lesions were over 60 years. 94% of benign lesions were less than 10 mm in diameter, while 88% of malignant lesions exceeded this size. Most small polypoid lesions of the gallbladder are benign and remain static for years. Age more than 60 years and polyp size more than 10 mm are the most important factors predicting malignancy in polypoid lesions of the gallbladder. Other risk factors include concurrent gallstone, solitary polyps and symptomatic polyps. Cholecystectomy is the treatment of choice