Category Archives: Gallbladder

Gallbladder polyps: CONCLUSIONS

Gallbladder polyps are common in the adult population. The majority of PLG are cholesterol polyps; thus, most PLG have a low malignant potential. We suggest resection of polyps in patients with compatible symptoms, including biliary-type pain and dyspepsia. In addition, … Continue reading

Gallbladder polyps: CLINICAL MANAGEMENT OF GALLBLADDER POLYPS Part 2

Based on the available evidence, we agree with the recommendations of Boulton and Adams, with one exception (Figure 3). We suggest that the indications for resection in asymptomatic patients with small polyps (less than 10 mm in diameter) be expanded … Continue reading

Gallbladder polyps: CLINICAL MANAGEMENT OF GALLBLADDER POLYPS Part 1

The management of patients with PLG requires the resolution of three key questions: • Which patients with PLG should undergo resection? • If a resection is planned, what is the optimal surgical approach? • How often should lesions be monitored … Continue reading

Gallbladder polyps: RADIOLOGICAL ASSESSMENT OF GALLBLADDER POLYPS Part 2

Computed tomography (CT) scanning can also aid in the diagnosis of gallbladder polyps. Unenhanced CT scans, however, can miss up to 60% of lesions that were initially visualized by ultrasound. A combined approach of unenhanced and enhanced CT scanning in … Continue reading

Gallbladder polyps: RADIOLOGICAL ASSESSMENT OF GALLBLADDER POLYPS Part 1

The ultrasonographic diagnosis of PLG requires the identification of hyperechoic material protruding into the gallbladder lumen (Figures 1 and 2). These echoes are characterized by the absence of shift with positional change; they may or may not cast an acoustic … Continue reading

Gallbladder polyps: NATURAL HISTORY OF PLG Part 2

Few studies have prospectively investigated the natural history of unresected gallbladder polyps. Eelkema et al reported no cases of gallbladder cancer in 113 patients fol-lowed-up for 15 years after the diagnosis of PLG on cholecystography. This study was limited, however, … Continue reading

Gallbladder polyps: NATURAL HISTORY OF PLG Part 1

A major concern in the management of the patient with PLG is the potential for malignant transformation, although the relationship between gallbladder polyps and cancer is controversial. Aldridge and Bismuth and others have argued that there is a polyp-cancer sequence, … Continue reading

Gallbladder polyps: CLINICAL SIGNIFICANCE OF GALLBLADDER POLYPS Part 3

Several other reports support the importance of polyp size in differentiating benign from malignant lesions. Koga et al reported a retrospective study of 411 patients who had undergone cholecystectomy; 32 patients had benign polyps and eight patients had malignancies. In … Continue reading

Gallbladder polyps: CLINICAL SIGNIFICANCE OF GALLBLADDER POLYPS Part 2

For example, in a study of 74 patients with resected gallbladders and small polyps (smaller than 2.0 cm in diameter), cholesterol polyps were found in 44 cases (59%), adenomas in five cases (7%), cancers in six cases (8%), and other … Continue reading

Gallbladder polyps: CLINICAL SIGNIFICANCE OF GALLBLADDER POLYPS Part 1

The frequency of symptoms in patients with PLG is difficult to evaluate due to inadequacies of studies in the available literature. Symptoms were not assessed in most of the population-based, ultrasonographic prevalence studies. In a study evaluating the natural history … Continue reading

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