When should gallbladder polyps be treated surgically?

This study was performed to better understand the best surgery timing for gallbladder polyps (GP).

The objective was to determine the potential for malignant transformation and the best timing for surgery in GP, based on an assessment of the clinical symptomatology and on the results of the imaging and histopathological examinations.

Age, gender, clinical symptoms, preoperative ultrasound findings, and the results of the postoperative histopathological examination were retrospectively assessed in a total of 2,656 patients undergoing cholecystectomy in Department of General Surgery, Hitit University School of Medicine, Çorum, Turkey, between 2008 and 2013.

From a total of 2,656 patients undergoing cholecystectomy in our unit between 2008 and 2013, 96 subjects were found to have the following types of GP: 66.6% (n = 64) had cholesterol polyps, 13.54% (n = 13) had adenomyomatous polyps, 8.33% (n = 8) had adenocarcinoma, 7.2% (n = 7) had inflammatory polyps, and 4.16% (n = 4) had hyperplastic polyps. Also, 85.4% of these patients (n = 82) had a single polyp only, while 14.6% (n = 14) had 2 polyps. The polyp size in patients with adenocarcinoma was 9 mm, 10 mm and 12 mm in 2, 4 and 2 patients, respectively. The mean age of patients with adenocarcinoma was 60 years (55-74), all of whom had solitary polyps.

In patients over 50 years of age with co-existent cholelithiasis and GP exceeding 10 mm, surgical treatment should be undertaken due to the risk of malignancy. Other patients with polyps less than 10 mm in size should be followed up in 6-month intervals using ultrasound examination.