Which is the best imaging method to diagnose gallbladder carcinoma in patients with asymptomatic gallbladder polyps?

Abstract

patients underwent for intent of curative resection. 13 out 19 were resectable. The median age was 65.6 years old. 27% were male and 73% were women. Pain was present on 58,8%. Jaundice was present on 78%. Cholecystits on 15,6%, cholelithiasis on 29,41%. Liver metastases were found on 34 patients at the moment of the diagnosis. Radical cholecystectomy was the procedure on 13 patients. Postoperative care in ICU was 0, 73 days. Morbidity 30e60 days was 2% and post operative mortality rate was 0%. Adenocarcinoma was the most frequent pathology. Analysis: Gallbladder cancer is a complex pathology not well studied in Colombia. The experience after 24 months reported 51 cases and only 19 underwent for surgery and only 13 were resectable Multidisciplinary team was the key to have acceptable morbidity and mortality. Conclusions: Gallbladder cancer needs more attention on Colombia's public Health. Our small serie is significant on terms of the number of cases in a short period of time. Purpose: To determine the natural history of gallbladder (GB) polyps less than 10 mm incidentally detected at ultrasonography (US) and to propose management guidelines for these lesions. Method: A database search for "polyp" in all US examinations of the GB between January 1, 2008, and December 31, 2014 at a single institution was performed. All subsequent US reports were reviewed to determine changes in GB polyp size. The electronic medical record was searched to obtain clinical and pathologic follow-up. Results: GB Polyps were identified in 108 patients (Male e 81%, Females e 19%) with Median age e 50.9 years. Majority of polyps were detected during comprehensive health check up or during ultrasound abdomen evaluation for pain abdomen.The mean size of the polyps were 4.7 ± 2.15 mm (range of 1 mm to 15 mm). On follow up USG at 3 months, Polyp was of same size in 43% of the patients, it showed complete resolution in 32%, and in 12% the size of polyp had reduced. Only 10% had increase in size. Out of 956 cholecystectomies done, 20 (1.67%) were for GB Polyps (17-abdominal pain, 3-family history of GB cancer). Out of 20 that were operated, only 8 GB specimens (37%) had polyps on histopathology and remaining had stones.None of them showed any evidence of dysplasia or neoplasia.Ultrasound abdomen had a low sensitivity (39%). Conclusions: The risk of GB malignancy resulting from incidentally detected polyps is extremely low. Incidentally detected GB polyps measuring 10 mm less may require no additional follow-up, although further studies are required to substantiate.