Journal List > Korean J Gastroenterol > v.53(6) > 1006555

Bang: Natural Course and Treatment Strategy of Gallbladder Polyp

Abstract

The polypoid lesions of gallbladder have explosively increased with enhanced feasibility of transabdominal ultrasonography. Most of small polyps less than 10 mm are benign and remain static for a long period. In small polyps, three to six month intervaled ultrasonography is warranted in the initial follow-up, but the duration of follow-up period is not clarified. The polypoid lesions larger than 10 mm show a quite different feature. They showed a remarkable risk of malignancy (34-88%) and should be treated by surgery. Furthermore, age more than 50 years and combined gallstone are important factors predicting malignancy in polypoid lesions of gallbladder. In addition, other factors including solitary polyp and the presence of symptoms are considered as risk factors. Laparoscopic cholecystectomy is a golden standard therapy for these polyps unless the suspicion of malignancy is high. The gallbladder polyps remain a problem of concern to both doctors and patient with the worry of malignancy. Thus, the comprehensive understanding of natural coruse of gallbladder polyp and risk factors of malignancy should be kept in mind.

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Fig. 1.
Microscopic feature of cholesterol polyp. Lipid laden macrophage containing polyp was observed (H&E staining, ×100).
kjg-53-336f1.tif
Fig. 2.
Microscopic feature of the adenomatous polyp. The polyp composed of glandular structure with tall columnar epithelium and fibrous stroma. In the center, dilated gland and vessels sur-rounded by loose connective tissue was noted (H&E staining, ×40).
kjg-53-336f2.tif
Fig. 3.
Treatment algorithm of gallbladder polyps.
kjg-53-336f3.tif
Table 1.
Histologic Classification of Gallbladder Polyps
Benign neoplastic polyps Benign non-neoplastic polyp Malignant polyp
Epithelial Hyperplasia Adenocarcinoma
Adenoma, papillary Adenomatous Miscellaneous
Adenoma, nonpapillary Adenomyomatous Mucinous cystadenoma
Supporting tissues Heterotropia Squamous cell carcinoma
Hemangioma Gastric mucosa Adenoacanthoma
Lipoma Intestinal mucosa
Leiomyoma Pancreas
Granular cell tumor Liver
Polyp
Inflammatory
Cholesterol
Miscellaneous
Fibroxanthogranulomatous inflammation
Parasitic infection
Others
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