Gall Bladder Polyp

                  Types :

  1. Cholesterol polyp
  2. Adenomyoma
  3. Inflammatory polyp
  4. Adenoma
  5. Miscellaneous
  •        – Fibroma
  •       – Lipoma

Predictors of gall bladder malignancy of GB polyp

  • – Polyp size >10mm
  • – Age > 60 years… the strongest predictor of neoplastic disease
  • – Presence of concurrent gall stone
  • – Single polyp
  • – Symptomatic polyp

Clinical features and diagnosis

  • – Usually asymptomatic
  • – Exceptional cases
  •             • Biliary pain
  •             • Acalculous cholecystitis
  •            • Hemobilia
  • – One third of patients with GB polyps identified on USG have no polyp in GB at cholecystectomy

 

                                           Treatment of GB Polyp

  • Patients with biliary pain + US evidence of both polyp & stone in GB…..elective cholecystectomy
  • Polyp size > 10 mm or large ……elective laparoscopic cholecystectomy
  • If polyp size is 6-9 mm…..management is debatable but periodic surveillance is prudent
  • – Polyp size <6 mm…..no periodic surveillance
  • – Polyp size 18 mm….signigficant risk of malignancy….prompt cholecystectomy if possible

 


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