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2013 | 85 | 11 | 625-629
Tytuł artykułu

Laparoscopic cholecystectomy in the treatment of gallbladder polypoid lesions – 15 years of experience

Treść / Zawartość
Warianty tytułu
Języki publikacji
EN
Abstrakty
EN
Due to the constant increase of public health awareness and widespread “cancerophobia”, the progressively larger number of incidentally diagnosed gall-bladder polyps became the source of anxiety, which leads patients and physicians to undertake therapeutic decisions, despite the absence of symptoms. The majority of gall-bladder polyps are benign. It is estimated that only 3 to 5% of polyps are malignant. Currently, there is lack of randomized control trials based on which the clear-cut criteria of qualification of patients with gall-bladder polyps for surgical procedure can be created. The aim of the study was to analyze gall-bladder polyps in patients who underwent laparoscopic cholecystectomy in the 2nd Department of General Surgery, Jagiellonian University Collegium Medicum. Material and methods. The retrospective study was conducted on 5369 patients who underwent laparoscopic cholecystectomy in the 2nd Department of General Surgery, Jagiellonian University Collegium Medicum with special attention to 152 (2.8%) patients in whom gall-bladder polyps were diagnosed preoperatively. Qualification criteria for surgery, surgical treatment results, and histopathological examination results were also analyzed. Results. Amongst the 5369 patients qualified for laparoscopic cholecystectomy, 152 (2.8%) were diagnosed with gall-bladder polyps during the preoperative ultrasound examinations. Postoperative histopathological examinations of 41 (27%) patients confirmed the presence of gall-bladder polyps. In 102 (67%) patients, only gall-stones were diagnosed without previously described polyps during the ultrasound examination. Analysis of the histopathological examination results revealed the presence of benign lesions in 35 (23.35%) patients. In 5 (3%) patients the presence of an adenoma, and in one (0.65%) the presence of adenocarcinoma were confirmed. Conclusions. Based on the conducted study and previous personal experience in the treatment of patients with gall-bladder polyps, we believe that due to the potential risk of neoplastic transformation, patients with polyps larger than 10 mm in diameter and polyps of proven rapid growth should be qualified for laparoscopic cholecystectomy. Indications for surgical treatment also seem reasonable in case of patients with present polyps and coexisting right upper quadrant pain, even though the above-mentioned is connected with gall-bladder deposits.
Wydawca

Rocznik
Tom
85
Numer
11
Strony
625-629
Opis fizyczny
Daty
wydano
2013-11-01
online
2013-12-31
Twórcy
  • 2nd Department of General Surgery, Jagiellonian University Collegium Medicum in Cracow
  • 2nd Department of General Surgery, Jagiellonian University Collegium Medicum in Cracow
autor
  • 2nd Department of General Surgery, Jagiellonian University Collegium Medicum in Cracow
  • 2nd Department of General Surgery, Jagiellonian University Collegium Medicum in Cracow
  • 2nd Department of General Surgery, Jagiellonian University Collegium Medicum in Cracow
  • 2nd Department of General Surgery, Jagiellonian University Collegium Medicum in Cracow
  • Students’ Society of Science, 2nd Department of General Surgery, Jagiellonian University Collegium Medicum in Cracow
  • 2nd Department of General Surgery, Jagiellonian University Collegium Medicum in Cracow
  • 2nd Department of General Surgery, Jagiellonian University Collegium Medicum in Cracow
Bibliografia
  • 1. Hayashi Y, Liu JH , Moriguchi H et al.: Prevalence of polypoid lesions of the gall-bladder in urban and rural areas of Japan: comparison between 1988 and 1993. J Clin Gastroenterol 1996; 23(2): 158-9.
  • 2. Okamoto M, Okamoto H, Kitahara F et al.: Ultrasonographic evidence of association of polyps and stones with gall-bladder cancer. Am J Gastroenterol 1999. 94(2): 446-50.[PubMed][Crossref]
  • 3. Lin WR , Lin DY , Tai DI et al.: Prevalence of and risk factors for gall-bladder polyps detected by ultrasonography among healthy Chinese: analysis of 34 669 cases. J Gastroenterol Hepatol 2008; 23(6): 965-69.[WoS]
  • 4. Matos AS , Baptista HN , Pinheiro C et al.: Gall-bladder polyps: how should they be treated and when? Rev Assoc Med Bras 2010; 56(3): 318-21.[PubMed][Crossref]
  • 5. Bobrzyński A, Budzyński A, Krzywoń J i wsp.: Polip pęcherzyka żółciowego - wskazanie do cholecystektomii? Pol Przegl Chir 1999; 71: 903-07.
  • 6. Andren-Sandberg, A: Diagnosis and management of gall-bladder polyps. N Am J Med Sci 2012; 4(5): 203-11.
  • 7. Stinton, LM, Shaffer EA : Epidemiology of gallbladder disease: cholelithiasis and cancer. Gut Liver 2012; 6(2): 172-87.[WoS][Crossref][PubMed]
  • 8. Wysocki A, Bobrzyński A, Krzywoń J i wsp.: Laparoskopowa cholecystektomia a rak pęcherzyka żółciowego. Pol Przegl Chir 1998; 70: 802-08.
  • 9. Marangoni G, Hakeem A, Toogood GJ et al.: Treatment and surveillance of polypoid lesions of the gall-bladder in the United Kingdom. HPB 2012; 14(7): 435-40.[Crossref][WoS]
  • 10. Park KW , Kim SH , Choi SH et al.: Differentiation of nonneoplastic and neoplastic gall-bladder polyps 1 cm or bigger with multi-detector row computed tomography. J Comput Assist Tomogr 2010; 34(1): 135-39.[WoS][Crossref]
  • 11. Irie H, Kamochi N, Nojiri J et al.: High b-value diffusion-weighted MRI in differentiation between benign and malignant polypoid gall-bladder lesions. Acta Radiol 2011; 52(3): 236-40.[WoS][Crossref]
  • 12. Gallahan WC , Conway JD : Diagnosis and management of gall-bladder polyps. Gastroenterol Clin North Am 2010; 39(2): 359-67.[PubMed][Crossref]
  • 13. Collett JA , Allan RB, Chisholm RJ et al.: Gallbladder polyps: prospective study. J Ultrasound Med 1998; 17(4): 207-11.
  • 14. Moriguchi H, Tazawa J, Hayashi Y et al.: Natural history of polypoid lesions in the gall-bladder.Gut 1996; 39(6): 860-62.[Crossref][PubMed]
  • 15. Sun XJ, Shi JS , Han Y et al.: Diagnosis and treatment of polypoid lesions of the gall-bladder: report of 194 cases. Hepatobiliary Pancreat Dis Int 2004; 3(4): 591-94.
  • 16. Corwin MT, Siewert B, Sheiman RG et al.: Incidentally detected gall-bladder polyps: is follow -up necessary? - Long-term clinical and US analysis of 346 patients. Radiology 2011; 258(1): 277-82.[WoS]
  • 17. Jang JY , Kim SW , Lee SE et al.: Differential diagnostic and staging accuracies of high resolution ultrasonography, endoscopic ultrasonography, and multidetector computed tomography for gall-bladder polypoid lesions and gall-bladder cancer. Ann Surg 2009; 250(6): 943-49.[WoS]
  • 18. Colecchia A, Larocca A, Scaioli E et al.: Natural history of small gall-bladder polyps is benign: evidence from a clinical and pathogenetic study. Am J Gastroenterol 2009; 104(3): 624-29.[PubMed][Crossref]
  • 19. Boulton, RA , Adams DH : Gall-bladder polyps: when to wait and when to act. Lancet 1997; 349(9055): 817.
  • 20. Shinkai, H., Kimura W, Muto T: Surgical indications for small polypoid lesions of the gall-bladder. Am J Surg 1998; 175(2): 114-17.
  • 21. Ito H, Hann LE, D’Angelica M et al.: Polypoid lesions of the gall-bladder: diagnosis and followup. J Am Coll Surg 2009; 208(4): 570-75.
  • 22. Chattopadhyay D, Lochan R, Balupuri S et al.: Outcome of gall-bladder polypoidal lesions detected by transabdominal ultrasound scanning: a nine year experience. World J Gastroenterol 2005; 11(14): 2171-73. [PubMed]
Typ dokumentu
Bibliografia
Identyfikatory
Identyfikator YADDA
bwmeta1.element.-psjd-doi-10_2478_pjs-2013-0094
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