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Gastroenterology & Hepatology: Open Access

Case Report Volume 2 Issue 2

Gallbladder Polyps, Surgical Indications According to their Size and Morphology

Nelson Carrillo, Miguel Perez Central

Department of Gastroenterology, University of Venezuela, Venezuela

Correspondence: Nelson Carrillo, University of Venezuela, Libertador Avenue, Angostura Building, 7 Floor, Office 7B, Caracas, Venezuela, Tel 58-212-7632202, Fax 58-212-9917903

Received: February 01, 2015 | Published: April 7, 2015

Citation: Carrillo N, Central MP (2015) Gallbladder Polyps, Surgical Indications According to their Size and Morphology.Gastroenterol Hepatol Open Access 2(2):00035. DOI: 10.15406/ghoa.2015.02.00035

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Abstract

A case is presented of a 40 years old female with gallbladder polyp with an early adenocarcinoma.

Keywords: Gallbladder polyp, early gallbladder adenocarcinoma

Case

A 40 years old female patient is studied by vague symptoms, on ultrasonography of the gallbladder, vesicular polyp 15 mm in diameter was found (Figure 1). Laboratory tests, and upper Endoscopy were normal. A laparoscopic cholecystectomy was done. The pathologic examination showed a superficial mucosal adenocarcinoma without infiltration of the rest of the wall of the gallbladder. The outcome was good.

Discussion

When doing an ultrasound of the gallbladder and find unique or multiple polyps leads to the question what is the most appropriate behaviour. The gallbladder polyps are pre-malignant lesions and there are reports that the size limits 10 mm in diameter as an indication of cholecystectomy.1–5 Ultrasound of the gallbladder is a routine study in the evaluation of patients with or without symptoms, which allows the diagnosis of these lesions in asymptomatic people. If polyps are small, with a size less than 10 mm, it is recommended periodic monitoring for every 4-6 months and measure on each test and observe its structure and shape (Figure 2 & 3). If increase in size or change in its morphology, should be suspected malignancy and cholecystectomy should be indicated,6 but if the size is greater than 10 mm and is irregular in the first examination , cholecystectomy should be done without waiting, because there is a 88 % chance to be a gallbladder carcinoma7 ( Figure 4). The cancer of the gallbladder that causes symptoms is usually an advanced lesion with a poor prognosis and no curative treatment. We therefore recommend that the gallbladder polyp 10 mm or more in diameter, should undergo laparoscopic cholecystectomy and thus the local dissemination of a posible early tumor lesion is avoided.8–21

Figure 1 A large and irregular polyp, 15 mm in diameter in the gallbladder neck.

Figure 2 Several small polyps in the gallbladder.

Figure 3 An unique and small polyp in the gallbladder, 8 mm in diameter.

Figure 4 A greater polyp in the gallbladder, 12 mm in diameter.

Acknowledgements

None.

Conflicts of interest

The author declares there is no conflict of interest.

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