Document Detail


Incidentally detected gallbladder polyps: is follow-up necessary?--Long-term clinical and US analysis of 346 patients.
MedLine Citation:
PMID:  20697115     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To determine the natural history of gallbladder (GB) polyps incidentally detected at ultrasonography (US) and to propose management guidelines for these lesions based on polyp size.
MATERIALS AND METHODS: The HIPAA-compliant study was approved by the institutional review board, and informed consent was waived. A database search for "polyp" in all US examinations of the GB between January 1, 1999, and December 31, 2001, at a single institution was performed. All subsequent US reports were reviewed to determine changes in GB polyp size. The electronic medical record was searched to obtain clinical and pathologic follow-up.
RESULTS: Three hundred forty-six patients (mean age, 51.6 years; range, 20-93 years) with GB polyps were included. There were 156 men (45%) and 190 women (55%). US follow-up (mean, 5.4 years; range, 2-11.5 years) was performed in 149 patients (43%). Polyp size was stable in 90 (60%) polyps, decreased in eight (5%), increased in one (1%), and resolved in 50 (34%). Forty-two patients (12%) underwent cholecystectomy, revealing 13 (31%) GBs with polypoid lesions, 24 (57%) with stones and no polyps, and five (12%) with neither a stone nor a polypoid lesion. Clinical follow-up (mean, 8 years; range, 5-10.4 years) was performed in 155 patients (45%). No patient had clinical evidence of GB-related disease. Overall, no cases of GB malignancy were identified in 346 patients. Mean polyp size was 5.0 mm (range, 1-18 mm). No neoplastic polyps were found at 1-6 mm, one neoplastic polyp was seen at 7-9 mm, and two neoplastic polyps were found at 10 mm or larger.
CONCLUSION: The risk of GB malignancy resulting from incidentally detected polyps is extremely low. Incidentally detected GB polyps measuring 6 mm or less may require no additional follow-up. Data are inconclusive regarding polyps 7 mm or greater, and further studies are warranted.
Authors:
Michael T Corwin; Bettina Siewert; Robert G Sheiman; Robert A Kane
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Publication Detail:
Type:  Journal Article     Date:  2010-08-09
Journal Detail:
Title:  Radiology     Volume:  258     ISSN:  1527-1315     ISO Abbreviation:  Radiology     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2010-12-24     Completed Date:  2011-02-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  277-82     Citation Subset:  AIM; IM    
Copyright Information:
© RSNA, 2010
Affiliation:
Department of Radiology, Beth Israel Deaconess Medical Center, 1 Deaconess Rd, CC/W 308, Boston, MA 02215, USA. corwinmichael@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Cholecystectomy
Female
Gallbladder Diseases / pathology,  ultrasonography*
Gallbladder Neoplasms / ultrasonography
Humans
Incidental Findings
Male
Middle Aged
Polyps / pathology,  ultrasonography*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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