Diagnosis and operative indications for polypoid lesions of the gallbladder
A. Koga, K. Watanabe, T. Fukuyama, S. Takiguchi and F. Nakayama
Department of Surgery I, Kyushu University Faculty of Medicine, Fukuoka, Japan.
In 411 patients undergoing cholecystectomy, benign polyps were present in
32 gallbladders and malignant polyps were present in eight. Histologically,
cholesterol polyps accounted for most of the benign lesions, and all the
malignant lesions were adenocarcinomas. Gallstones coexisted in 50% of the
malignant lesions and endoscopic retrograde cholangiography revealed
anomalous pancreaticobiliary junctions in three of five patients with
malignant lesions. Sixty-nine percent of patients with benign lesions were
under 60 years of age, whereas 75% of those with malignant lesions were
over 60. Ninety-four percent of the benign lesions were under 1.0 cm in
diameter, while 88% of the malignant lesions exceeded this size. Spread and
size of the tumor showed a close correlation. Therefore, size of the tumor
is a vital indicator in the treatment of polypoid lesions of the
gallbladder, and a malignancy should be considered when the tumor exceeds
1.0 cm in diameter.
