Surgical management of polypoid lesions of the gallbladder

Background: With improvements in ultrasonography more polypoid lesions of t he gallbladder (PLGs) are being detected. The management of these is contro versial. Methods: The demographic, radiological and pathological data of 38 patients with ultrasonographically detected PLGs were reviewed. A Medline search fo r such lesions was performed and a review of the literature is presented. Results: Thirty-four patients underwent cholecystectomy and four were advis ed against or declined operation. Of the 34 who had cholecystectomy, 11 had macroscopic and histopathologically proven PLGs. Of these, seven had chole sterol polyps, two had adenomas, one had a carcinoid tumour and one had an adenocarcinoma of the gallbladder. One patient had a histopathologically no rmal gallbladder. The remainder had chronic cholecystitis with or without g allstones. All of the patients with neoplastic lesions of the gallbladder h ad solitary polyps greater than 1.0 cm in diameter. Conclusion: A protocol for the management of ultrasonographically detected PLGs is proposed. In this protocol it is suggested that patients with a PLG should undergo surgery if they are symptomatic, or if the PLG is 1.0 cm or more in diameter.