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 if surgical resection is deemed unnecessary?
In a recent review of the literature, Boulton and Adams suggested that all patients with gallbladder polyps who are symptomatic, have lesions greater than 10 mm in diameter or have complicating factors that increase the risk of malignancy (age over 50 years or concurrent gallstones) should undergo resection. According to Boulton and Adams, all others should be followed-up cautiously every three to six months with repeat abdominal ultrasounds. Generally, this seems to the consensus of several recent studies. These suggestions are based on the finding that most benign polyps are less than 10 mm in diameter, whereas malignant polyps usually exceed this diameter. Others recommend cholecystectomy for all patients with gallbladder polyps, independent of size or symptoms, while some suggest resection of small lesions (less than 10 mm in diameter) if the lesions are single, sessile, rapidly growing or associated with wall thickening, or if the patient is symptomatic or over the age of 60 years. This is your great chance – buy asthma inhalers to take full advantage of best quality drugs.