[Surgical indications in gallbladder polyps].
| Autor: | Morera-Ocón FJ; Servicio de Cirugía General, Hospital de Requena, Valencia, España. fmoreraocon@aecirujanos.es, Ballestín-Vicente J, Calatayud-Blas AM, de Tursi-Rispoli LC, Bernal-Sprekelsen JC |
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| Jazyk: | Spanish; Castilian |
| Zdroj: | Cirugia espanola [Cir Esp] 2013 May; Vol. 91 (5), pp. 324-30. Date of Electronic Publication: 2012 Dec 13. |
| DOI: | 10.1016/j.ciresp.2012.04.018 |
| Abstrakt: | Introduction: The surgery of gallbladder polyps is not well defined due to the lack of evidence-based clinical guidelines. Objective: To analyse the management of polyps in Spain, and a review of the literature and treatment standards. Material and Methods: The reports on cholecystectomy with gallbladder polyps (GBP) were extracted from the Pathology data base. Patients subjected to surgery with a diagnosis of GBP were identified in the Surgery data base. A single list was prepared and a review was made of the clinical histories, including, age, gender, clinical data, ultrasound report, and histopathology report. Results: A total of 30 patients, with a median age of 51 years (range 22-83), 21 of whom were female, were included. The ultrasound diagnosis was GBP in 19 patients, GBP and calculi in 7 cases, and calculi with no polyps in 4 cases. Other diagnoses concurrent with GBP were multiple haemangiomas (3), large single simple cyst (1), and multiple simple cysts (1). Eleven patients had typical pain (biliary origin), 5 of which showed no calculi on ultrasound. Eight had non-specific pain, which persisted in 3 cases after the cholecystectomy. Pseudopolyps were found in 20 gallbladders, and true polyps in 4 cases. In 3 cases, polyps were not found in the pathology study. Conclusions: The ultrasound report must specify the size, shape, and number of polyps. Patients with biliary type pain would benefit from a cholecystectomy. The probability of malignancy is minimum if the GBP is less than 10mm and aged under 50 years, and a cholecystectomy is not required. A GBP greater than 10mm should be an indication of cholecystectomy. (Copyright © 2011 AEC. Published by Elsevier España, S.L. All rights reserved.) |
| Databáze: | MEDLINE |
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