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Gallbladder Polyps – An Outcome Study Kannan RY, Brown C, White E, Jones HG, Kambal A, Feroz A, Rasheed A Gwent Institute for Minimal Access Surgery • To date, Introduction Awaiting Surgery Awaiting Clinic No diagnosis patients underwent 5% of screening ultrasonography 9% cholecystectomy (US). (Fig 1). The majority are benign, 24% 22% (Fig. 3) however some do have a malignant potential. Lap Chole Other diagnosis Under Investigation 14 symptomatic • Gallbladder polyps are reported in 7% Fig 1. US detected GB polyp 9% 29% • The preoperative confirmation of the nature of these lesions is Fig 3. Symptomatic patients "difficult" and the optimal management remains to be ill-defined. Stones Psudo-polyp Adenoma Aims • Neoplastic polyps To determine the nature and natural history of ultrasound-detected gallbladder polyps (GBP) and propose a follow up and a therapeutic strategy based on size and symptomatology. (adenomatous) operated patients . 14% were found in two 14% (Fig 4). Methods 72% • This is an interim report from an ongoing study. A retrospective search of a prospective US database for "polyp" in gallbladder for the period between January 1st and December 31st 2010 was conducted. • A database was then constructed including demographics, clinical presentation, principal symptoms, management and pathology. Fig 4. Histology reports • There was no comment on the polyp’s size in seventy reports and there was no clear therapeutic or follow up plan in more than 62% of US-detected cases . Conclusions • Histologic findings were analyzed in patients who underwent cholecystectomy, and change in polyp size was determined in • Our preliminary data indicate that the majority of the patients who underwent serial US imaging. US detected ‘polypoid lesions’ are incidental findings and are not •The electronic medical record was searched to obtain clinical and true epithelial polyps. pathologic data and follow-up • The majority of patients with pre-operative diagnosis of Results symptomatic polyps had cholelithiasis on post-operative • 5594 consecutive ultrasound reports were obtained from the histology. radiology department computerized database. All scans were performed by trained ultrasonographers. • US-detected gallbladder polyps were reported in 185 patients • The current management strategy of asymptomatic gallbladder polyps relies on its size and hence must be included in the radiology reports. (72 males & 113 females) with an age range of 16 – 59 years •All patients with polyp’s size greater than 10mm should offered ( Median age of 47 years). • The majority of polyps were detected Symptomatic Asymptomatic surgery. incidentally during the workup of 24 % conditions other than suspected • Small (<10mm) asymptomatic gallbladder polyps need better characterization by MRI or EUS. gall bladder one (Fig. 2). 140 • Long term follow up of non-operated patients is necessary to Fig 2. Clinical presentation allow better understanding of this pathological entity.