Related Experiment Videos
In primary sclerosing cholangitis, gallbladder polyps are frequently malignant
Daniel C Buckles1, Keith D Lindor, Nicholas F Larusso
1Division of Gastroenterology and Hepatology, Mayo Medical School, Clinic, and Foundation, Rochester, Minnesota 55905, USA.
The American Journal of Gastroenterology
|May 17, 2002
Summary
Gallbladder masses in primary sclerosing cholangitis (PSC) patients are often cancerous. Cholecystectomy (gallbladder removal) is recommended for PSC patients with gallbladder polyps due to high malignancy rates.
Area of Science:
- Gastroenterology
- Hepatology
- Surgical Oncology
Background:
- Primary sclerosing cholangitis (PSC) patients face increased biliary tract cancer risk.
- Gallbladder polyps are usually benign in the general population, posing a management dilemma in PSC.
Purpose of the Study:
- To determine the prevalence of gallbladder cancer in PSC patients with gallbladder masses who underwent cholecystectomy.
Main Methods:
- Retrospective review of 102 PSC patients who underwent cholecystectomy at Mayo Clinic (1977-1999).
Main Results:
- 13.7% of PSC patients had gallbladder masses; 57% of these masses were malignant (adenocarcinomas).
- Gallbladder epithelial cell dysplasia was associated with malignancy (33% in benign, 57% in malignant cases).
- Primary gallbladder adenocarcinoma patients had a 66% 36-month survival post-cholecystectomy.
Conclusions:
- Gallbladder neoplasms in PSC patients are malignant in 40-60% of cases.
- A dysplasia-carcinoma sequence is suggested in PSC, similar to ulcerative colitis.
- Cholecystectomy should be considered for PSC patients with gallbladder polyps; otherwise, careful follow-up is essential.