Gallbladder polyps between ultrasound and histopathology

Abstract

Background Gallbladder polyps (GBP) are rare. Ultrasound is the most widely used screening method for Gallbladder pathology. Aims We aim to analyse polyps identified in gallbladders removed by laparoscopy over a 14-year period, and to assess the ability of conventional ultrasound to differentiate GBPs from stones. Methods This is a retrospective study of 11,391 patients who underwent laparoscopic cholecystectomy from 2002–2016. Data concerning patients' characteristics, preoperative ultrasound findings, number and size of lesions, histologic features of polyps and gallbladder were collected. Results Forty-six patients had GBP(s) (0.4 per cent). Mean age was 54(range 17-85), 67.4 per cent were females. Body mass index (BMI) was 30 (range 19-43). GBP(s) were single in 63 per cent of cases. Polyp size ranged between 0.2 and 2.2cm (average 1cm). Preoperative ultrasound successfully differentiated polyps from stones in nine cases (20 per cent). The most common histopathologic pattern was hyperplastic polyps in 18 cases (39.1), followed by cholesterol polyps (28.3 per cent), adenomyoma (13 per cent) and adenoma (8.7 per cent). The rest (10.9 per cent) were malignant polyps (adenocarcinoma). Polyps were associated with chronic cholecystitis in 40/46 patients. Conclusion GBPs are rare. Hyperplastic polyps are the commonest in our region, probably due to chronic inflammation induced by gallstones. Although ultrasound seems to be sensitive to gallbladder lesions; its utility to differentiate polyps from stones is relatively low. Since one tenth of polyps were hiding malignancy, cholecystectomy is advised especially in elderly people.