Polypoid lesions of the gallbladder: Report of 100 cases with special reference to operative indications

Background. The nature of polypoid lesions of the gallbladder is difficult to define before operation, and surgical indications still remain controver sial. The nim of this study was to identify characteristics of each type of polypoid lesion of the gallbladder and idications for surgery. Methods. Clinical data were retrospectively correlated with the histopathol ogic char characteristics of polypoid lesions in 100 patients who had chole cystectomy. Results. There were 74 benign polypoid lesions, including 39 cholesterol po lyps, 20 adenomas, and 15 with adenomyomatous hyperplasia and 26 malignant polypoid lesions. Twenty-seven, percent of patients with benign polyps and 73 percent of patients with malignant polyps were over GO years of age. Pol ypoid lesions of the gallbladder, were diagnosed by preoperative ultrasonog raphy in only 36 patients (36%). All types of polypoid lesions of the gallb ladder whether benign or malignant, were frequently solitary and gallstones coexisted in the majority of patients with all polypoid lesions of the gal lbladder except cholesterol polyps. The lesions were > 10 nm in 88% of the malignant polyps and in only 15% of the benign polyps. Conclusions. The risk factors for malignancy were file age of the patient ( > 60 years) the coexistence of gallstones, and the size of the polypoid le sions (>10 mm in diameter). In asymptomatic patients, cholecystectomy can b e justified if there are risk factors for malignancy.