Laparoscopic cholecystectomy for gallbladder polyp is significant in the prevention of gallbladder cancer?

Hun Ryong, Gum-Chol Jang, Dae-Mo Ryu, Chung-Sa Ji


Background: Aim is to evaluate the significance of laparoscopic cholecystectomy for gallbladder polyp by analyzing the accidental incidence of gallbladder cancer diagnosed following surgery for gallbladder polyp and occurrence rate of postcholecystectomy syndrome.
Methods: We analyzed several clinical factors and pathohistological findings, and occurrence rate of postcholecystectomy syndrome among patients undergoing the laparoscopic cholecystectomy for gallbladder polyp.
Results: A total of 292 patients undergoing laparoscopic cholecystectomy for gallbladder polyp was employed. The average age was 39.8±10.2 years (22–69 years). The percentage of male was 40.4% (118 patients) and female was 59.6% (174 patients). The incidence of gallbladder cancer was 6.8% (20 patients) in the pathohistological findings of gallbladder polyp. The reason of surgery for gallbladder polyp was mostly prevention of gallbladder cancer (191 patients, 65.4%), maldigestion (66 patients, 22.6%), pain (24 patients, 8.2%), fever (7 patients, 2.4%) and nausea (4 patients, 1.4%). The percentage of gallbladder polyp with stone was 4.8% (14 patients). Solitary polyp was 33.2% (97 patients) and multiple polyp was 66.8% (195 patients). The size of gallbladder polyp was less than 1 centimeter 75% (219 patients), 1 to 2 centimeter 21.9% (64 patients) and over 2 centimeter 3.1% (9 patients). Two cases confirmed as gallbladder cancer pathohistologically was less than 5 mm (4, 5 mm) . the rate of postcholecystectomy syndrome was 18.8% (55 out of 292 patients). They mainly suffered from pain in the right upper quadrant (13%, 8 patients), maldigestion (17.8%, 52 patients). And their syndrome occurred mostly in 6 months after operation (78.2%, 43 out of 55 patients).
Conclusions: The risk factors of gallbladder polyp malignancy were the size of the gallbladder polyp and the age of the patients. We couldn’t exclude the malignancy risk of gallbladder polyp though the size was small and all gallbladder polyp needs to be resected laparoscopically.