Araştırma Makalesi
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GALLBLADDER POLYPS: EVALUATION OF 106 PATIENTS AND REVIEW OF THE LITERATURE

Yıl 2019, Cilt: 52 Sayı: 1, 28 - 33, 14.03.2019

Öz



Introduction: Gallbladder polyps are derived from the mucosal surface of the gallbladder, and they also have risk of malignancy. In this study, we aimed to share our clinical experience in
managing the gallbladder polyps.

Methods: Between January 2013- October 2017, 3348 patients underwent cholecystectomy surgery in our clinic, and 106 patients having been operated for gallbladder polyps were included in current

study. All patients were evaluated retrospectively according to their demografic findings, clinical symptoms, abdominal ultrasonography results and
histopathologic results.

Results: The mean age of the patients were 47.0±12.04 (18-77) and 72 of patients were female. According to the preoperative evaluation, the mean size of the polyps were 5.25±3.62. Histopathologic examination revealed that no malignancy was observed in any patients but neoplastic polyps were detected at a 77-year-old female patient (0.94%). Cholesterol polyps (% 41.5)were seen most commonly. Any other pathology were detected in 13 of the patients (%12.26).


Conclusion: The most important criterias for the surgical treatment decision of gallbladder polyps are the polyp size,and it must be greater or equal to 10mm and the patients must be elderly. In patients who has <10mm polyp, surgical treatment should be advised more selectively to patients who have additional risk factors.


Kaynakça

  • 1)Persley KM. Gallbladderpolyps. CurrTreatOptionsGastroenterol 2005;8(2):105-8.
  • 2)Moriguchi H, Tazawa J, Hayashi Y, Takenawa H, Naka-yama E, Marumo F, et al. Natural history of polypoidlesions in thegallbladder. Gut 1996;39:860-2. 3)Terzi C, Sokmen S, Seckin S, Albayrak L, Ugurlu M. Polypoidlesions of thegallbladder: Report of 100 caseswithspecialreferencetooperativeindications. Surgery 2000; 127(6): 622-7.
  • 4)Yıldırım M, Erkan N, Yakan S, Boz A, Vardar E. Safra-kesesi polipleri: 33 olgunun retrospektif analizi. ADÜ Tıp Fakültesi Dergisi 2005;6(1):27-30.
  • 5)Velidedeoğlu M, Çitgez B, Arıkan AE, Ayan F. Is it necessary to perform prophylactic cholecystectomy for all symptomatic gallbladder polyps diagnosed with ultrasound? Turk J Surg 2017; 33(1): 25-8.
  • 6)Dilek ON. Safra kesesi polipleri ve tedavisi. J SurgArts 2008;1(2):12-9.
  • 7)Sarkut P, Kılıçturgay S, Ozer A, Oztürk E, Yılmazlar T. Gallbladder polyps: Factors affecting surgical decision. World J Gastroenterol 2013; 19(28): 4526-30.
  • 8)De Matos ASB, Baptista HIN, Pinheiro C, Martinho F. Gallbladder polyps: How should they be treated and when? RevAssocMedBras 2010; 56(3): 318-21.
  • 9)Kwon W, Jang JY, Lee SE, Hwang DW, Kim SW. Clinicopathologic Features of Polypoid Lesions of the Gallbladder and Risk Factors of Gallbladder Cancer. J KoreanMedSci 2009; 24(3): 481-7.
  • 10)Csendes A, Burgos AM, Csendes P, Smok G, Rojas J. LateFollow-Up of Polypoid Lesions of the Gallbladder Smaller Than 10 mm. AnnSurg 2001; 234(5): 657-60.
  • 11)Cheon YK, Cho WY, Lee TH, Cho YD, Moon JH, Lee JS, et al. Endoscopic ultrasonography does not differentiate neoplastic from nonneoplastic small gallbladder polyps. World J Gastroenterol 2009; 15(19): 2361-6.
  • 12)Andren-Sandberg A. Diagnosisand Management of Gallbladder Polyps. N Am J Med Sci 2012; 4: 203-11.
  • 13) Lee JK, Hahn SJ, Kang HW, Jung JG, Choi HS, Lee JH, et al. Visceral obesity is associated with gallbladder polyps. Gut Liver 2016; 10: 133-9.
  • 14)Choi YS, Do JH, Seo SW, Lee SE, Oh HC, Min YJ, et al. Prevalence and Risk Factors of Gallbladder Polypoid Lesions in a Healthy Population. YonseiMed J 2016;57(6):1370-5.
  • 15)Cha BH, Hwang JH, Lee SH, Kim JE, Cho JY, Kim H, et al. Pre-operative factors that can predict neoplastic polypoid lesions of the gallbladder. World J Gastroenterol 2011; 17(17): 2216-22.
  • 16)Yüksel A, Coşkun M, Turgut HT, Ozyıldız M, Yazıcıoğlu MB, Yıldız SY. Ultrasonografide Safra Kesesinde Polip Saptanan Hastaların Postoperatif Histopatolojik Bulgularının Analizi. Kocaeli MJ 2016; 5(1): 11-15.
  • 17)Terzioğlu SG, Kılıc MO, Sapmaz A, Karaca AS. Predictive factors of neoplastic gallbladder polyps: Outcomes of 278 patients. Turk J Gastroenterol 2017; 28: 202-6.
  • 18)Akyurek N, Salma B, Ilkorucu O, Sare M, Tatlıcıoglu E. Ultrasonography in the diagnosis of true gallbladder polyps: the contradiction in the literature. HPB 2005; 7(2): 155-8.
  • 19)Saleh H, Walz D, Ehrinpreis M. Polypoid Lesions of the Gallbladder: Diagnostic and Management Challenges. J GastrointestinLiverDis 2008; 17(3): 251-3.
  • 20)Yang HL, Sun YG, Wang Z. Polypoidlesions of the gallbladder: diagnosis and indications for surgery. Br J Surg 1992; 79: 227-9.
  • 21)Jang JY, Kim SW, Lee SE, Hwang DW, Kim EJ, Lee JY, et al. Differential diagnostic and staging accuracies of high resolution ultrasonography, endoscopic ultrasonography, and multidetector computed tomography for gallbladder polypoid lesions and gallbladder cancer. AnnSurg 2009;250:943-9.
  • 22)Ching BH, Yeh BM, Westphalen AC, Joe BN, Qayyum A, Coakley FV. CT differentiation of adenomyomatosis and gallbladder cancer. AJR Am J Roentgenol 2007;189:62-6.
  • 23)Choi WB, Lee SK, Kim MH, Seo DW, Kim HJ, Kim DI, et al. A new strategy to predict the neoplastic polyps of the gallbladder based on a scoring system using EUS. Gastrointest Endosc 2000;52:372-9.
  • 24)Sadamoto Y, Oda S, Tanaka M, Harada N, Kubo H, Eguchi T, et al. A useful approach to the differential diagnosis of small polypoid lesions of the gallbladder, utilizing an endoscopic ultrasound scoring system. Endoscopy 2002;34:959-65.
  • 25)Kimura K, Fujita N, Noda Y, Kobayashi G, Ito K. Differential diagnosis of large-sized pedunculated polypoid lesions of the gallbladder by endoscopic ultrasonography: a prospective study. J Gastroenterol 2001 Sep;36:619-22.
  • 26)Koh T, Taniguchi H, Kunishima S, Yamagishi H. Possibility of Differential Diagnosis of Small Polypoid Lesions in the Gallbladder Using FDG-PET. Clin Positron Imaging 2000;3:213-8.
  • 27)Lee H, Kim K, Park I, Cho H, Gwak G, Yang K, et al. Preoperative predictive factors for gallbladder cholesterol polyp diagnosed after laparoscopic cholecystectomy for polypoid lesions of gallbladder. Ann Hepatobiliary Pancreat Surg 2016; 20(4):180-6.
  • 28)Park JY, Hong SP, Kim YJ, Kim HJ, Kim HM, Cho JH, et al. Long-term follow up of gallbladder polyps. J Gastroenterol Hepatol 2009;24:219-22.
  • 29)Zielinski MD, Atwell TD, Davis PW, Kendrick ML, Que FG. Comparison of surgically resected polypoid lesions of the gallbladder to their pre-operativeultrasound characteristics. J GastrointestSurg 2009;13:19-25.
  • 30)Mainprize KS, Gould SW, Gilbert JM. Surgical management of polypoid lesions of the gallbladder. Br J Surg2000;8 7:414-7.

SAFRA KESESİ POLİPLERİ: 106 OLGU EŞLİĞİNDE LİTERATÜRÜN DEĞERLENDİRİLMESİ

Yıl 2019, Cilt: 52 Sayı: 1, 28 - 33, 14.03.2019

Öz

Giriş: Safra kesesi polipleri, safra kesesi
mukozasından köken alan ve malignite riski taşıyan lezyonlardır. Çalışmamızda,
safra kesesi polipleri ile ilgili kliniğimizin tecrübelerini paylaşmayı
amaçladık.

Yöntemler: Kliniğimizde Ocak 2013- Ekim 2017
tarihleri arasında 3348 hastaya kolesistektomi ameliyatı yapılmıştır; safra
kesesi polibi tanısıyla opere edilen 106 hasta bu çalışmaya dahil edilmiştir.
Hastalar demografik özellikleri, klinik ve abdominal ultrasonografi bulguları,
histopatolojik verileri açısından retrospektif olarak değerlendirildi.

Bulgular: Hastaların yaş ortalaması 47.0±12.04
(18-77) olup olguların 72’si kadındı. Preoperatif değerlendirmede polip boyutu
ortalama 5.25±3.61 mm (2-32mm) idi. Histopatolojik incelemede hiçbir hastada
malignite gözlenmedi; 77 yaşında kadın bir hastada (%0.94) neoplastik polip
tespit edildi. En sık kolesterol polibi görüldü (% 41.5). Hastaların 13’ünde
(%12.26) hiçbir patoloji saptanmadı. 

 









Sonuç: Safra kesesi polipleri cerrahi
tedavi kararında polip boyutunun ≥10 mm olması ve hastanın ileri yaşta olması
dikkat edilmesi gereken en önemli risk kriterleridir. Polip boyutu <10 mm
olup ek risk faktörleri taşıyan hastalarda cerrahi karar alırken daha seçici
davranılmalıdır.

Kaynakça

  • 1)Persley KM. Gallbladderpolyps. CurrTreatOptionsGastroenterol 2005;8(2):105-8.
  • 2)Moriguchi H, Tazawa J, Hayashi Y, Takenawa H, Naka-yama E, Marumo F, et al. Natural history of polypoidlesions in thegallbladder. Gut 1996;39:860-2. 3)Terzi C, Sokmen S, Seckin S, Albayrak L, Ugurlu M. Polypoidlesions of thegallbladder: Report of 100 caseswithspecialreferencetooperativeindications. Surgery 2000; 127(6): 622-7.
  • 4)Yıldırım M, Erkan N, Yakan S, Boz A, Vardar E. Safra-kesesi polipleri: 33 olgunun retrospektif analizi. ADÜ Tıp Fakültesi Dergisi 2005;6(1):27-30.
  • 5)Velidedeoğlu M, Çitgez B, Arıkan AE, Ayan F. Is it necessary to perform prophylactic cholecystectomy for all symptomatic gallbladder polyps diagnosed with ultrasound? Turk J Surg 2017; 33(1): 25-8.
  • 6)Dilek ON. Safra kesesi polipleri ve tedavisi. J SurgArts 2008;1(2):12-9.
  • 7)Sarkut P, Kılıçturgay S, Ozer A, Oztürk E, Yılmazlar T. Gallbladder polyps: Factors affecting surgical decision. World J Gastroenterol 2013; 19(28): 4526-30.
  • 8)De Matos ASB, Baptista HIN, Pinheiro C, Martinho F. Gallbladder polyps: How should they be treated and when? RevAssocMedBras 2010; 56(3): 318-21.
  • 9)Kwon W, Jang JY, Lee SE, Hwang DW, Kim SW. Clinicopathologic Features of Polypoid Lesions of the Gallbladder and Risk Factors of Gallbladder Cancer. J KoreanMedSci 2009; 24(3): 481-7.
  • 10)Csendes A, Burgos AM, Csendes P, Smok G, Rojas J. LateFollow-Up of Polypoid Lesions of the Gallbladder Smaller Than 10 mm. AnnSurg 2001; 234(5): 657-60.
  • 11)Cheon YK, Cho WY, Lee TH, Cho YD, Moon JH, Lee JS, et al. Endoscopic ultrasonography does not differentiate neoplastic from nonneoplastic small gallbladder polyps. World J Gastroenterol 2009; 15(19): 2361-6.
  • 12)Andren-Sandberg A. Diagnosisand Management of Gallbladder Polyps. N Am J Med Sci 2012; 4: 203-11.
  • 13) Lee JK, Hahn SJ, Kang HW, Jung JG, Choi HS, Lee JH, et al. Visceral obesity is associated with gallbladder polyps. Gut Liver 2016; 10: 133-9.
  • 14)Choi YS, Do JH, Seo SW, Lee SE, Oh HC, Min YJ, et al. Prevalence and Risk Factors of Gallbladder Polypoid Lesions in a Healthy Population. YonseiMed J 2016;57(6):1370-5.
  • 15)Cha BH, Hwang JH, Lee SH, Kim JE, Cho JY, Kim H, et al. Pre-operative factors that can predict neoplastic polypoid lesions of the gallbladder. World J Gastroenterol 2011; 17(17): 2216-22.
  • 16)Yüksel A, Coşkun M, Turgut HT, Ozyıldız M, Yazıcıoğlu MB, Yıldız SY. Ultrasonografide Safra Kesesinde Polip Saptanan Hastaların Postoperatif Histopatolojik Bulgularının Analizi. Kocaeli MJ 2016; 5(1): 11-15.
  • 17)Terzioğlu SG, Kılıc MO, Sapmaz A, Karaca AS. Predictive factors of neoplastic gallbladder polyps: Outcomes of 278 patients. Turk J Gastroenterol 2017; 28: 202-6.
  • 18)Akyurek N, Salma B, Ilkorucu O, Sare M, Tatlıcıoglu E. Ultrasonography in the diagnosis of true gallbladder polyps: the contradiction in the literature. HPB 2005; 7(2): 155-8.
  • 19)Saleh H, Walz D, Ehrinpreis M. Polypoid Lesions of the Gallbladder: Diagnostic and Management Challenges. J GastrointestinLiverDis 2008; 17(3): 251-3.
  • 20)Yang HL, Sun YG, Wang Z. Polypoidlesions of the gallbladder: diagnosis and indications for surgery. Br J Surg 1992; 79: 227-9.
  • 21)Jang JY, Kim SW, Lee SE, Hwang DW, Kim EJ, Lee JY, et al. Differential diagnostic and staging accuracies of high resolution ultrasonography, endoscopic ultrasonography, and multidetector computed tomography for gallbladder polypoid lesions and gallbladder cancer. AnnSurg 2009;250:943-9.
  • 22)Ching BH, Yeh BM, Westphalen AC, Joe BN, Qayyum A, Coakley FV. CT differentiation of adenomyomatosis and gallbladder cancer. AJR Am J Roentgenol 2007;189:62-6.
  • 23)Choi WB, Lee SK, Kim MH, Seo DW, Kim HJ, Kim DI, et al. A new strategy to predict the neoplastic polyps of the gallbladder based on a scoring system using EUS. Gastrointest Endosc 2000;52:372-9.
  • 24)Sadamoto Y, Oda S, Tanaka M, Harada N, Kubo H, Eguchi T, et al. A useful approach to the differential diagnosis of small polypoid lesions of the gallbladder, utilizing an endoscopic ultrasound scoring system. Endoscopy 2002;34:959-65.
  • 25)Kimura K, Fujita N, Noda Y, Kobayashi G, Ito K. Differential diagnosis of large-sized pedunculated polypoid lesions of the gallbladder by endoscopic ultrasonography: a prospective study. J Gastroenterol 2001 Sep;36:619-22.
  • 26)Koh T, Taniguchi H, Kunishima S, Yamagishi H. Possibility of Differential Diagnosis of Small Polypoid Lesions in the Gallbladder Using FDG-PET. Clin Positron Imaging 2000;3:213-8.
  • 27)Lee H, Kim K, Park I, Cho H, Gwak G, Yang K, et al. Preoperative predictive factors for gallbladder cholesterol polyp diagnosed after laparoscopic cholecystectomy for polypoid lesions of gallbladder. Ann Hepatobiliary Pancreat Surg 2016; 20(4):180-6.
  • 28)Park JY, Hong SP, Kim YJ, Kim HJ, Kim HM, Cho JH, et al. Long-term follow up of gallbladder polyps. J Gastroenterol Hepatol 2009;24:219-22.
  • 29)Zielinski MD, Atwell TD, Davis PW, Kendrick ML, Que FG. Comparison of surgically resected polypoid lesions of the gallbladder to their pre-operativeultrasound characteristics. J GastrointestSurg 2009;13:19-25.
  • 30)Mainprize KS, Gould SW, Gilbert JM. Surgical management of polypoid lesions of the gallbladder. Br J Surg2000;8 7:414-7.
Toplam 29 adet kaynakça vardır.

Ayrıntılar

Bölüm Araştırma Makalesi
Yazarlar

Mustafa Taner Bostancı

Görkem Gündoğan Bu kişi benim

Ahmet Seki Bu kişi benim

Koray Koşmaz

Aysun Gökçe Bu kişi benim

Mehmet Saydam

Serra Özbal

Zafer Ergül Bu kişi benim

Yayımlanma Tarihi 14 Mart 2019
Gönderilme Tarihi 15 Ocak 2018
Yayımlandığı Sayı Yıl 2019 Cilt: 52 Sayı: 1

Kaynak Göster

AMA Bostancı MT, Gündoğan G, Seki A, Koşmaz K, Gökçe A, Saydam M, Özbal S, Ergül Z. SAFRA KESESİ POLİPLERİ: 106 OLGU EŞLİĞİNDE LİTERATÜRÜN DEĞERLENDİRİLMESİ. Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi. Mart 2019;52(1):28-33.