To find the risk factors of gallbladder cancer and to establish the treatment principles of gallbladder polypoid lesions, 79 cases of gallbladder polypoid lesions were analysed in terms of histology, size, age, symptom and operative methods.
There
were
34 cholesterol polyps (43.0%), 25 invasive carcinomas (31.6%), 10 adenomas (12.7%), 8 inflammatory polyps (10.1%), one adenomatous hyperplasia and one adenomyomatous hyperplasia. Out of 10 adenomas, 2 had adenoma with carcinoma in situ and 2 had
adenoma
with atypism. Three cases out of 25 invasive carcinomas had adenoma residue. The size of benisgn polypoid lesions had the range of 2 to 30 mm. For malignant polypoid lesions, the range of size was 6 to 80 mm, and 3 cases were between 5 and 10 mm.
Cancer
incidence of lesions with the size of 5 to 10 mm was 11.1% and that of the lesions larger than 40 mm was 100%, mean age of patients with benign polyp (45.6 years) was younger than that of those with malignant polyp (59.3 years). And especially in
male
atietns, 90% of those with malignant lesions were over 55 years and 89% of benign lesions were under 55 years. Gallstones were present in 16 cases of benign polyps (30.8%) and in 5 cases of malignant polyps (18.5%). radical operations were
perfomred in
16 cases for 27 malignant polyps (59.3%).
In conclusion, gallbladder polypoid lesions larger than 5 mm in the largest diameter should be surgically removed, especially in the aged patients. In asymptomatic polypoid lesions under 5 mm, close follow-up is necessary by ultrasonography.
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