medigraphic.com
ISSN 2594-1518 (Electronic)
ISSN 1405-0099 (Print)

2005, Number 1

<< Back Next >>

Cir Gen 2005; 27 (1)

Polypoid injuries of the gallbladder. Indications for cholecystectomy and most frequent histopathological findings

Sánchez FP, Niño SJ, Millán RG, Sánchez RK, Blanco BR

Language: Spanish
References: 18
Page: 42-46
PDF size: 49.47 Kb.


ABSTRACT

Introduction:Frequency of polypoid lesions of the gallbladder is from 0. 004 to 13.8%, predominating in the third, fourth, and fifth decades of life.
Objective:To inform the frequency and the most constant histopathological results regarding polypoid lesions of the gallbladder.
Setting:Third level health care hospital.
Patients and methods:The clinical records of patients subjected to cholecystectomy were reviewed, and from these we identified and analyzed those with polypoid lesions. The polypoid lesion was defined as a protrusion of the mucosa to the vesicular lumen. We analyzed age, gender, pathological antecedents, symptoms, signs, laboratory tests and cabinet studies, macroscopic findings, histopathological analysis, and evolution.
Results:In a period of 16 years (1988-2003), 3,316 patients subjected to cholecystectomy were recorded, of these 216 presented polypoid lesions. There were 143 women and 73 men, average age of 50. Adenomyosis, cholesterol polyps, and intestinal metaplasia were the most frequent histopathological findings; four cases of in situ cancer were detected. Most lesions were sessile and smaller than 10 mm. The clinical manifestation in most was a sensation of abdominal heaviness or they were asymptomatic. All patients evolved satisfactorily.
Conclusion:The prevalence of polypoid lesions of the gallbladder in our study was of 6.5% and cancer frequency was of 1.85%. Cholecystectomy is indicated for lesions larger than 10 mm or in symptomatic patients.


REFERENCES

  1. Segawa K, Arisawa T, Niwa Y, Susuki T, Tsukamoto Y, Goto H, et al. Prevalence of gallbladder polyps among apparently healthy Japanese: ultrasonographic study. Am J Gastroenterol 1992; 87: 630-3.

  2. Shinchi K, Kono S, Honjo S, Imanishi K. Epidemiology of gallbladder polyps: A ultrasonographic study of male self-defense officials in Japan. Scand J Gastroenterol 1994; 29: 7-10.

  3. Jorgensen T, Jensen KH. Polyps in the gallbladder. A prevalence study. Scan J Gastroenterol 1990; 25: 281-6.

  4. Christensen AH, Isaac KG. Benign tumors and pseudotumors of the gallbladder. Report of 180 cases. Arch Pathol 1970; 90: 423-32.

  5. Yang H, Sun Y, Wang Z. Polypoid lesions of the gallbladder: diagnosis and indications for surgery. B J Surg 1992; 79: 227-9.

  6. Koga A, Watanabe K, Fukuyama T, Takiguchi S, Nakayama F. Diagnosis and operative indications for polypoid lesions of the gallbladder. Arch Surg 1988; 123: 26-9.

  7. Mainprize KS, Gould WT, Gilbert JM. Surgical management of polypoid lesions of the gallbladder. Br J Surg 2000; 87: 414-7.

  8. Sugiyama M, Xie XY, Saito M. Differential diagnosis of small polypoid lesions of the gallbladder: the value of endoscopic ultrasonography. Ann Surg 1999; 229: 498-504.

  9. Azuma T, Yoshikawa T, Araida T, Takasaki K. Differential diagnosis of polypoid lesions of the gallbladder by endoscopic ultrasonography. Am J Surg 2001; 181: 65-70.

  10. Meguid MM, Aun F, Bradford ML. Adenomyomatosis of the gallbladder. Am J Surg 1984; 147: 260-2.

  11. Aldridge MC, Gruffaz F, Castaing D, Bismuth H. Adenomyomatosis of the gallbladder. A premalignant lesion? Surgery 1991; 109: 107-10.

  12. Katoh T, Nakai T, Hayashi S, Satake T. Noninvasive carcinoma of the gallbladder arising in localized adenomyomatosis. Am J Gastroenterol 1988; 83: 670-4.

  13. Aldridge MC, Bismuth H. Gallbladder cancer: the polyp-cancer sequence. Br J Surg 1990; 77: 363-4.

  14. Kim DH, Kim SR, Song SY. A large fibrous polyp of the gallbladder mimicking a polypoid carcinoma. J Gastroenterol 2003; 38: 1009-12.

  15. Gouma DJ. When are gallbladder polyps malignant? HPB Surg 2000; 11: 428-30.

  16. Vogt DP. Gallbladder disease: an update on diagnosis and treatment. Clev Clin J Med 2002; 69: 977-84.

  17. Kubota K, Bandai Y, Noie T, Ishizaki Y, Teruya M, Maruuchi M. How should polypoid lesions of the gallbladder be treated in the era of laparoscopic cholecystectomy? Surgery 1995; 117: 481-7.

  18. Jones-Monahan KS, Gruenberg JC, Finger JE. Isolated small gallbladder polyps: an indication for cholecystectomy in symptomatic patients. Am Surg 2000; 66: 716-9.




2020     |     www.medigraphic.com