Management strategies for gallbladder polyps: is it possible to predict malignant gallbladder polyps?

Gallbladder (GB) polyps are commonly encountered in clinical practice, and are found more frequently as the number of medical screening examinations increases. The aim of this study was to determine optimal practice guideline for surgical treatment and follow-up of GB polyps.

Data from healthy subjects of Seoul National University Hospital (SNUH) Health Care System of Gangnam Center were used to investigate the true prevalence of GB polyps. We also enrolled 689 patients with GB polyps diagnosed at SNUH from May 1(st), 1988 to April 30(th), 2006.

The GB polyp prevalence was 6.1% (7.1% in males and 4.8% in females). The median follow-up duration in the 689 study patients was 60 months, and 139 (20%) of them had polyps >/=10 mm in size. Twenty-five of the 180 patients who underwent cholecystectomy had adenocarcinomas. The chi(2) test was used to identify which of the following were risk factors of malignancy: age, sex, symptoms, size, rate of growth, multiplicity, accompanying stones, and shape. Age (>/=57 years), presence of symptoms, size (>/=10 mm), and shape (sessile) were found to be statistically significant risk factors by univariate analysis. However, multivariate analysis identified only age (>/=57 years) and size (>/=10 mm) as independent predictors of malignancy.

The present study shows that GB polyps >/=10 mm in size in patients aged >/=57 years are the independent factors predicting malignancy of the GB.