Role of laparoscopic cholecystectomy in the management of polypoid lesionsof the gallbladder

This retrospective clinicohistopathologic study was performed to delineate the role of laparoscopic cholecystectomy in the management of polypoid lesi ons of the gallbladder. One hundred forty-three consecutive patients who ha d a preoperative sonographic diagnosis of polypoid lesions of the gallbladd er with a diameter less than 1.5 cm and who underwent laparoscopic cholecys tectomy at Cathay General Hospital were included in the analysis. Histopath ologic study showed that 22 (15.4%) patients had true tumors, including ade noma (16), adenoma with focal adenocarcinoma (2), adenocarcinoma (3), and c arcinoid tumor (1). Tumorlike lesions were found in 121 (84.6%) patients an d included cholesterol polyp (106), adenomyomatous hyperplasia (10), inflam matory polyp (3), and papillary hyperplasia (2). The mean diameter of malig nant polypoid lesions of the gallbladder was 1.35 +/- 0.42 cm, which was si gnificantly larger than that of cholesterol polyps (0.66 +/- 0.40 cm, P = 0 .0001) but not significantly larger than that of adenomyomatous hyperplasia s (1.12 +/- 0.42 cm) and adenomas (1.08 +/- 0.47 cm). The mean age of patie nts with malignant polypoid lesions of the gallbladder (61.2 +/- 13.3 years old) was significantly older than that of patients with adenomyomatous hyp erplasia (46.6 +/- 13.4 years, P = 0.03), cholesterol polyps (44.5 +/- 10.5 years, P = 0.0003), and adenomas (41.4 +/- 9.4 years, P = 0.0008). Clinica l follow-up showed that most (98.6%) patients benefited from the minimal in vasiveness of laparoscopic cholecystectomy with satisfactory surgical resul ts. We conclude that laparoscopic cholecystectomy is a reliable, safe, and minimally invasive biopsy procedure and definite management of polypoid les ions of the gallbladder with a diameter less than 1.5cm.