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Is it necessary to perform prophylactic cholecystectomy for asymptomatic subjects with gallbladder polyps and gallstones?

Authors :
Choi SY
Kim TS
Kim HJ
Park JH
Park DI
Cho YK
Sohn CI
Jeon WK
Kim BI
Source :
Journal of gastroenterology and hepatology [J Gastroenterol Hepatol] 2010 Jun; Vol. 25 (6), pp. 1099-104.
Publication Year :
2010

Abstract

Background and Aims: The purpose of the present study was to determine the clinical characteristics of subjects with gallbladder polyps and cholelithiasis compared with those with gallbladder polyps only.<br />Methods: Between August 1999 and December 2005, 176 subjects with gallbladder polyps and cholelithiasis (study group) by transabdominal ultrasonography performed during a medical check-up at our institution were recruited and compared with a control group of 185 subjects who had gallbladder polyps only.<br />Results: No significant difference in the mean interval change (delta) of polyp size during the follow-up period between the study and control groups (0.85 +/- 1.39 mm vs 0.84 +/- 1.58 mm, respectively, P = 0.927) was noted. A significantly higher proportion (9/176 [5.1%]) of examinees in the study group had attacks of acute cholecystitis compared with the control group (1/185 [0.5%], P < 0.01). By multivariate logistic regression analysis, gallbladder wall thickening on initial ultrasonography (odds ratio, 13.7; 95% confidence interval, 1.1-178.0; P = 0.046) and the interval increase in the size of the gallbladder polyps (odds ratio, 14.7; 95% confidence interval, 1.7-126.9; P = 0.014) were independent risk factors for cholecystectomy. No gallbladder cancer occurred during the follow-up period.<br />Conclusions: There was no significant difference in delta polyp size between the examinees with gallbladder polyps and cholelithiasis and those with gallbladder polyps only. Hence, a small proportion of subjects with gallbladder polyps and cholelithiasis, such as those with thickened gallbladder walls and an interval increase in the size of the gallbladder polyps are candidates for prophylactic cholecytectomy.

Details

Language :
English
ISSN :
1440-1746
Volume :
25
Issue :
6
Database :
MEDLINE
Journal :
Journal of gastroenterology and hepatology
Publication Type :
Academic Journal
Accession number :
20594225
Full Text :
https://doi.org/10.1111/j.1440-1746.2010.06288.x