Laparoscopic Cholecystectomy for Gallbladder Polyps: Is It Overtreatment?

Area of Science:

• Gastroenterology
• Surgical Oncology
• Abdominal Surgery

Background:

• Gallbladder polyps (GPs) are recognized risk factors for gallbladder cancer and indications for laparoscopic cholecystectomy (LC).
• Distinguishing benign GPs from potential malignancies or stones preoperatively is challenging without pathological evaluation.
• This study aimed to compare the indications and pathological outcomes of cholecystectomies performed for GPs.

Purpose of the Study:

• To analyze the indications and pathological results of cholecystectomy in patients with gallbladder polyps.
• To evaluate the prevalence of malignancy in gallbladder polyps requiring surgical intervention.
• To assess the diagnostic accuracy of ultrasonography (USG) in detecting gallbladder polyps.

Main Methods:

• Retrospective data analysis of patients who underwent laparoscopic cholecystectomy (LC) between August 2021 and August 2024.
• Inclusion criteria: patients undergoing LC for gallbladder polyps.
• Data collected: demographics, surgical details, indications, hospital stay, pathological outcomes, complications, and USG findings.

Main Results:

• 533 patients were included; 20 (3.75%) underwent surgery for GPs.
• The mean polyp size was 7.47 mm; 65% had multiple polyps.
• Pathological results: 55% pseudopolyp, 45% non-polyp. No carcinomas were found in GP surgeries; one malignancy was found in a gallstone surgery patient.
• USG sensitivity for polyp detection was 64.7%; complication rate was 1.5%.

Conclusions:

• The majority of gallbladder polyps treated with cholecystectomy are benign (pseudopolyp or adenoma).
• No gallbladder cancer was identified in patients operated on for polyps in this cohort.
• Further research is warranted to establish definitive surgical indications for gallbladder polyps.