Contribution of gallbladder polyp surgery to treatment

Surgery is the preferred treatment for gallbladder polyps, not only for relieving the symptoms but also for eliminating the potential risk of malignancy. In our study, we investigated whether patients who had undergone surgery truly had a surgical indication and beyond question required laparoscopic cholecystectomy due to malignancy.

185 patients who were prediagnosed with gallbladder polyps were operated in VKV American Hospital, Istanbul between January 2004 and July 2015. Retrospective data of all patients included patients’ age, gender, symptoms, preoperative ultrasonography, pathology reports, radiologic findings regarding the number and size of the polyps, and postoperative follow-up.

140 out of 185 patients were symptomatic before surgery. 85 patients (60.7 %) reported that their symptoms persisted after they had undergone surgery. 20 (14.3 %) of the patients with postoperatively persisting symptoms had no polyps in their pathologic examination. Only 35 out of 140 patients (25 %) reported relief of symptoms following surgery. Postoperative pathologic investigation revealed adenocarcinoma in only 1 patient and adenomatous polyps in 2 patients.

Postoperative pathologic investigations reveal only a very small percentage of premalignant and malignant polyps among patients who have undergone laparoscopic cholecystectomy. This finding clearly points out that we require new methods to differentiate cholesterol polyps from adenomatous polyps. Furthermore, the surgical indication criteria for patients with gall bladder polyps should be updated to prevent futile operations and morbidity.