Symptomatic Response After Laparoscopic Cholecystectomy for Symptomatic Gallbladder Polyps: A Patient Questionnaire

Area of Science:

• Gastroenterology
• Surgical Oncology
• Diagnostic Imaging

Background:

• Gallbladder polyps (GBPs) are common, but their symptomatic impact and optimal management remain debated.
• Laparoscopic cholecystectomy (LC) is standard for symptomatic gallstones, yet its efficacy for symptomatic GBPs requires further assessment.
• Pre-operative diagnostic accuracy of abdominal ultrasound (US) for GBPs influences surgical decision-making.

Purpose of the Study:

• To evaluate the effectiveness of LC in alleviating biliary symptoms associated with GBPs.
• To determine the positive predictive value (PPV) and negative predictive value (NPV) of US in pre-operatively identifying GBPs.
• To correlate symptom relief with polyp size and diagnostic accuracy.

Main Methods:

• Retrospective review of patients undergoing LC for symptomatic GBPs (2013-2022) at a tertiary hepatobiliopancreatic (HPB) center.
• Analysis of pre-operative US and post-operative histology reports.
• Post-operative symptom assessment via questionnaire using Accurx® software, correlated with polyp size and US findings.

Main Results:

• Eighty-nine percent of patients reported complete or major symptom improvement after LC.
• US demonstrated a PPV of 83.02% and NPV of 90.37% for detecting GBPs.
• Histology revealed GBPs in 21.6% of the cohort, with discrepancies between US findings and final histology noted.

Conclusions:

• LC is effective in managing symptomatic GBPs, leading to significant symptom resolution in the majority of patients.
• US is a valuable tool for GBP detection, but histological confirmation is essential due to potential discrepancies.
• Further randomized controlled trials are needed to refine surgical indications for symptomatic GBPs.