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 of PLG diagnosed via cholecystography, only 6% of patients were thought to have symptoms referable to the gallbladder. Surgical studies, on the other hand, have found a higher frequency of symptoms in patients with documented PLG, likely due to selection bias. For example, Terzi et al reported symptoms in 91% of 74 patients who had undergone cholecystectomy for benign PLG. The most frequently cited complaints included right upper quadrant or epigastric pain (98%), nausea and vomiting (51%), and dyspepsia (26%). Right upper quadrant tenderness was the most common physical finding (61%). There were no significant differences in symptoms between patients with benign PLG and those with malignant PLG, a finding that has been confirmed in other studies. Gallbladder polyps have also been implicated in cases of obstructive jaundice, acalculous cholecystitis and massive hemobilia. They may increase the risk of acute pancreatitis. Buy cheap drugs online fast – buy antibiotics online for you to enjoy a reliable pharmacy.
One of the major concerns regarding gallbladder polyps is the differentiation of benign from malignant masses. Although the majority of PLG are benign (approximately 75%, depending on the series), differentiation from malignant lesions can be challenging. Because carcinoma of the gallbladder usually presents late and has a dismal prognosis, lesions must be detected early, when still confined to the mucosa, to affect the prognosis. As a result, a wealth of literature has emerged in an attempt to identify characteristics that increase the likelihood of malignancy in PLG. Several characteristics, including the size, number and shape of the polyp (s), and the age of the patient, have emerged as important discriminating features.