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Handling Gallbladder Polyps: Single Center Experience

Yıl 2020, Cilt: 22 Sayı: 3, 445 - 449, 31.12.2020
https://doi.org/10.24938/kutfd.714875

Öz

Objective: Gallbladder polyps are the enlargements from the gallbladder wall towards the lumen. Non-neoplastic cholesterol polyps comprise the great majority of these structures. We aimed evaluating the operation indications and pathology results of patients who had been operated due to gallbladder polyps.
Material and Methods: The data belonging to 21 patients operated due to gallbladder polyps were examined retrospectively, from among 806 cholecystectomies performed in our clinic between January 2016 and December 2018.
Results: Twenty-one patients were identified. Thirteen of the patients (61,9%) were women and 8 (38,1%) were men. The median value for age was 47 and the ages of the participants varied between 18 and 77. It was found that 5 patients (23,8%) were operated for having polyp dimensions equal to or greater than 10 mm, 6 patients (28,6%) for having accompanying gallbladder stone, 6 patients (28,6%) due to an increase in polyp dimensions during follow up, 4 patients (19%) for being symptomatic. When the pathology results were examined, cholesterol polyp was found in 15 patients (71,4%), adenomyomatosis in 3 patients (14,3%), hyperplastic polyp in 1 patient (4,8%), pyloric gland adenoma in 1 patient (4,8%) and adenocarcinoma in 1 patient (4,8%).
Conclusion: We are of the opinion that cholecystectomy should be performed, when the diameter of the gallbladder polyp is measured as 10 mm and above, if the patient is over 50 years old, when an increase in the diameter of the followed polyp is observed and the polyp is accompanied by stones.

Kaynakça

  • 1. Wiles R, Varadpande M, Muly S, Webb J. Growth rate and malignant potential of small gallbladder polyps–systematic review of evidence. Surgeon. 2014;12(4):221-6.
  • 2. Patel K, Dajani K, Vickramarajah S, Huguet E. Five year experience of gallbladder polyp surveillance and cost effective analysis against new European consensus guidelines. HPB (Oxford). 2019;21(5):636-42.
  • 3. Guo J, Wu G, Zhou Z. Polypoid lesions of the gallbladder: report of 160 cases with special reference to diagnosis and treatment in China. Int J Clin Exp Pathol. 2015;8(9):11569-78.
  • 4. Sarkut P, Kilicturgay S, Ozer A, Ozturk E, Yilmazlar T. Gallbladder polyps: factors affecting surgical decision. World J Gastroenterol. 2013;19(28):4526-30.
  • 5. McCain RS, Diamond A, Jones C, Coleman HG. Current practices and future prospects for the management of gallbladder polyps: A topical review. World J Gastroenterol. 2018;24(26):2844-52.
  • 6. Wennmacker SZ, Van Dijk AH, Raessens JHJ, Van Laarhoven CJHM, Drenth JPH, De Reuver PR et al. Polyp size of 1 cm is insufficient to discriminate neoplastic and non-neoplastic gallbladder polyps. Surg Endosc. 2019;33(5):1564-71.
  • 7. Ake Andren Sanberg. Diagnosis and Management of Gallbladder Polyps. N Am J Med. Sci. 2012;4(5):203–11.
  • 8. Choi JH, Yun JW, Kim YS, Lee EA, Hwang ST, Cho YK et al. Pre-operative predictive factors for gallbladder cholesterol polyps using conventional diagnostic imaging. World J Gastroenterol. 2008;14(44):6831-4.
  • 9. Irie H, Kamochi N, Nojiri J, Egashira Y, Sasaguri K, Kudo S. High b-value diffusion-weighted MRI in differentiation between benign and malignant polypoid gallbladder lesions. Acta Radiol. 2011;52(3):236-40.
  • 10. Sugiyama M, Atomi Y, Yamato T. Endoscopic ultrasonography for differential diagnosis of polypoid gall bladder lesions: analysis in surgical and follow up series. Gut. 2000;46(2):250-4.
  • 11. Gurusamy KS, Abu-Amara M, Farouk M, Davidson BR. Cholecystectomy for gallbladder polyp. Cochrane Database Syst Rev. 2009;21;(1):CD007052.
  • 12. Park JK, Yoon YB, Kim YT, Ryu JK, Yoon WJ, Lee SH et al. Management strategies for gallbladder polyps: is it possible to predict malignant gallbladder polyps? Gut Liver. 2008;2(2):88-94.
  • 13. 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(2):219-22.
  • 14. Aldouri AQ, Malik HZ, Waytt J, Khan S, Ranganathan K, Kummaraganti S et al. The risk of gallbladder cancer from polyps in a large multiethnic series. Eur J Surg Oncol. 2009;35(1):48-51.
  • 15. Bhatt NR, Gillis A, Smoothey CO, Awan FN, Ridgway PF. Evidence based management of polyps of the gall bladder: a systematic review of the risk factors of malignancy. Surgeon. 2016;14(5):278-86.
  • 16. Cairns V, Neal CP, Dennison AR, Garcea G. Risk and cost-effectiveness of surveillance followed by cholecystectomy for gallbladder polyps. Arch Surg. 2012;147(12):1078-83.
  • 17. Wiles R, Thoeni RF, Barbu ST, Vashist YK, Rafaelsen SR, Dewhurst C et al. Management and follow-up of gallbladder polyps. Eur Radiol. 2017;27(9):3856-66.

SAFRA KESESİ POLİPLERİNE YAKLAŞIM: TEK MERKEZ DENEYİMİ

Yıl 2020, Cilt: 22 Sayı: 3, 445 - 449, 31.12.2020
https://doi.org/10.24938/kutfd.714875

Öz

Amaç: Safra kesesi polipleri, safra kesesi duvarından lümene doğru olan büyümedir. Büyük çoğunluğunu non-neoplastik olan kolesterol polipleri oluşturur. Çalışmamızda safra kesesi polibi nedeni ile opere edilen hastaların ameliyat endikasyonları ve patoloji sonuçlarını değerlendirmeyi amaçladık.
Gereç ve Yöntemler: Ocak 2016-Aralık 2018 yılları arasında, kliniğimizde yapılan 806 kolesistektomi içerisinden, safra kesesi polibi nedeni ile opere edilen 21 vakanın verileri retrospektif olarak incelendi.
Bulgular: Yirmi bir hasta tespit edildi. Hastaların 13'ü (%61,9) kadın, 8'i (%38,1) erkek olarak izlendi. Yaş ortanca değeri 47 olup, 18 ile 77 arasında idi. Hastaların 5'inin (%23,8) polip boyutu 10 mm ve üzerinde olduğu için, 6'sında (%28,6) polibe taş eşlik ettiği için, 6'sının (%28,6) takipte polip boyutunda artış olduğu için, 4'ünün (%19) ise semptomatik olduğu için opere edildiği gözlendi. Patoloji sonuçları incelendiğinde; 15 hastada (%71,4) kolesterol polibi, 3 hastada (%14,3) adenomiyomatozis, 1 hastada (%4,8) hiperplastik polip, 1 hastada (%4,8) pilorik gland adenomu ve 1 hastada (%4,8) adenokarsinom izlendi.
Sonuç: Safra kesesi polip çapı 10 mm ve daha büyük ölçüldüğünde, hasta yaşı 50'nin üzerinde ise, takip edilen polip çapında artış gözlendiğinde ve polibe taş eşlik ediyorsa kolesistektomi yapılması gerektiği kanaatindeyiz.

Kaynakça

  • 1. Wiles R, Varadpande M, Muly S, Webb J. Growth rate and malignant potential of small gallbladder polyps–systematic review of evidence. Surgeon. 2014;12(4):221-6.
  • 2. Patel K, Dajani K, Vickramarajah S, Huguet E. Five year experience of gallbladder polyp surveillance and cost effective analysis against new European consensus guidelines. HPB (Oxford). 2019;21(5):636-42.
  • 3. Guo J, Wu G, Zhou Z. Polypoid lesions of the gallbladder: report of 160 cases with special reference to diagnosis and treatment in China. Int J Clin Exp Pathol. 2015;8(9):11569-78.
  • 4. Sarkut P, Kilicturgay S, Ozer A, Ozturk E, Yilmazlar T. Gallbladder polyps: factors affecting surgical decision. World J Gastroenterol. 2013;19(28):4526-30.
  • 5. McCain RS, Diamond A, Jones C, Coleman HG. Current practices and future prospects for the management of gallbladder polyps: A topical review. World J Gastroenterol. 2018;24(26):2844-52.
  • 6. Wennmacker SZ, Van Dijk AH, Raessens JHJ, Van Laarhoven CJHM, Drenth JPH, De Reuver PR et al. Polyp size of 1 cm is insufficient to discriminate neoplastic and non-neoplastic gallbladder polyps. Surg Endosc. 2019;33(5):1564-71.
  • 7. Ake Andren Sanberg. Diagnosis and Management of Gallbladder Polyps. N Am J Med. Sci. 2012;4(5):203–11.
  • 8. Choi JH, Yun JW, Kim YS, Lee EA, Hwang ST, Cho YK et al. Pre-operative predictive factors for gallbladder cholesterol polyps using conventional diagnostic imaging. World J Gastroenterol. 2008;14(44):6831-4.
  • 9. Irie H, Kamochi N, Nojiri J, Egashira Y, Sasaguri K, Kudo S. High b-value diffusion-weighted MRI in differentiation between benign and malignant polypoid gallbladder lesions. Acta Radiol. 2011;52(3):236-40.
  • 10. Sugiyama M, Atomi Y, Yamato T. Endoscopic ultrasonography for differential diagnosis of polypoid gall bladder lesions: analysis in surgical and follow up series. Gut. 2000;46(2):250-4.
  • 11. Gurusamy KS, Abu-Amara M, Farouk M, Davidson BR. Cholecystectomy for gallbladder polyp. Cochrane Database Syst Rev. 2009;21;(1):CD007052.
  • 12. Park JK, Yoon YB, Kim YT, Ryu JK, Yoon WJ, Lee SH et al. Management strategies for gallbladder polyps: is it possible to predict malignant gallbladder polyps? Gut Liver. 2008;2(2):88-94.
  • 13. 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(2):219-22.
  • 14. Aldouri AQ, Malik HZ, Waytt J, Khan S, Ranganathan K, Kummaraganti S et al. The risk of gallbladder cancer from polyps in a large multiethnic series. Eur J Surg Oncol. 2009;35(1):48-51.
  • 15. Bhatt NR, Gillis A, Smoothey CO, Awan FN, Ridgway PF. Evidence based management of polyps of the gall bladder: a systematic review of the risk factors of malignancy. Surgeon. 2016;14(5):278-86.
  • 16. Cairns V, Neal CP, Dennison AR, Garcea G. Risk and cost-effectiveness of surveillance followed by cholecystectomy for gallbladder polyps. Arch Surg. 2012;147(12):1078-83.
  • 17. Wiles R, Thoeni RF, Barbu ST, Vashist YK, Rafaelsen SR, Dewhurst C et al. Management and follow-up of gallbladder polyps. Eur Radiol. 2017;27(9):3856-66.
Toplam 17 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Makaleler
Yazarlar

Uğur Kılınç 0000-0003-4573-4115

Ahmet Erdoğan 0000-0002-0126-4679

Ahmet Türkan 0000-0002-3065-5273

Yayımlanma Tarihi 31 Aralık 2020
Gönderilme Tarihi 5 Nisan 2020
Yayımlandığı Sayı Yıl 2020 Cilt: 22 Sayı: 3

Kaynak Göster

APA Kılınç, U., Erdoğan, A., & Türkan, A. (2020). SAFRA KESESİ POLİPLERİNE YAKLAŞIM: TEK MERKEZ DENEYİMİ. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi, 22(3), 445-449. https://doi.org/10.24938/kutfd.714875
AMA Kılınç U, Erdoğan A, Türkan A. SAFRA KESESİ POLİPLERİNE YAKLAŞIM: TEK MERKEZ DENEYİMİ. Kırıkkale Üni Tıp Derg. Aralık 2020;22(3):445-449. doi:10.24938/kutfd.714875
Chicago Kılınç, Uğur, Ahmet Erdoğan, ve Ahmet Türkan. “SAFRA KESESİ POLİPLERİNE YAKLAŞIM: TEK MERKEZ DENEYİMİ”. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi 22, sy. 3 (Aralık 2020): 445-49. https://doi.org/10.24938/kutfd.714875.
EndNote Kılınç U, Erdoğan A, Türkan A (01 Aralık 2020) SAFRA KESESİ POLİPLERİNE YAKLAŞIM: TEK MERKEZ DENEYİMİ. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi 22 3 445–449.
IEEE U. Kılınç, A. Erdoğan, ve A. Türkan, “SAFRA KESESİ POLİPLERİNE YAKLAŞIM: TEK MERKEZ DENEYİMİ”, Kırıkkale Üni Tıp Derg, c. 22, sy. 3, ss. 445–449, 2020, doi: 10.24938/kutfd.714875.
ISNAD Kılınç, Uğur vd. “SAFRA KESESİ POLİPLERİNE YAKLAŞIM: TEK MERKEZ DENEYİMİ”. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi 22/3 (Aralık 2020), 445-449. https://doi.org/10.24938/kutfd.714875.
JAMA Kılınç U, Erdoğan A, Türkan A. SAFRA KESESİ POLİPLERİNE YAKLAŞIM: TEK MERKEZ DENEYİMİ. Kırıkkale Üni Tıp Derg. 2020;22:445–449.
MLA Kılınç, Uğur vd. “SAFRA KESESİ POLİPLERİNE YAKLAŞIM: TEK MERKEZ DENEYİMİ”. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi, c. 22, sy. 3, 2020, ss. 445-9, doi:10.24938/kutfd.714875.
Vancouver Kılınç U, Erdoğan A, Türkan A. SAFRA KESESİ POLİPLERİNE YAKLAŞIM: TEK MERKEZ DENEYİMİ. Kırıkkale Üni Tıp Derg. 2020;22(3):445-9.

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