Management of polypoid lesions of the gallbladder

ABSTRACT

With the wide spread use of Ultrasonography [US], more polypoid lesions of the gallbladder [PLG] are being detected. The management of these is controversial. Fifty nine patients with an ultrasonographic diagnosis of PLG were reviewed to determine the reliability of US in the diagnosis of PLG and the indications for operation in this disease. Of the 59 patients operated on, PLG were demonstrated in the resected specimens in 55 cases. Benign lesions were present in 53 PLG, and malignant lesions in 2 patients. The size and number of PLG, and the presence of gallstones, all correlate with the nature of PLG. and these features are helpful in differentiating malignant from benign lesions before operation. US is a sensitive method for investigating PLG. Surgical treatment is indicated when PLG exceed one cm in diameter, when PLG are single in number, when PLG are associated with gallstones, or when clinical symptoms of PLG are apparent. Laparoscopic cholecystectomy [LC] is advised for lesions below 1 cm, while open approach is advised for larger ones