Introduction Gallbladder polyps are reported in 5% of screening ultrasonography

1. Gallbladder Polyps – An Outcome Study • To date, 14 symptomatic patients underwent cholecystectomy (Fig. 3) • Neoplastic polyps (adenomatous) were found in two operated patients (Fig 4). • There was no comment on the polyp’s size in seventy reports • and there was no clear therapeutic or follow up plan in more than • 62% of US-detected cases . Kannan RY, Brown C, White E, Jones HG, Kambal A, Feroz A, Rasheed A Gwent Institute for Minimal Access Surgery • Introduction • Gallbladder polyps are reported in • 5% of screening ultrasonography • (US). (Fig 1). The majority are benign, • however some do have a malignant • potential. • The preoperative confirmation of the nature of these lesions is "difficult" and the optimal management remains to be ill-defined. Fig 1. US detected GB polyp Fig 3. Symptomatic patients Aims To determine the nature and natural history of ultrasound-detected gallbladder polyps (GBP) and propose a follow up and a therapeutic strategy based on size and symptomatology. . • Methods • This is an interim report from an ongoing study.A retrospective • search of a prospective US database for "polyp" in gallbladder for the period between January 1st and December 31st 2010 was conducted. • A database was then constructed including demographics, clinical presentation, principal symptoms, management and pathology. • Histologic findings were analyzed in patients who underwent • cholecystectomy, and change in polyp size was determined in patients who underwent serial US imaging. • The electronic medical record was searched to obtain clinical and pathologic data and follow-up Fig 4. Histology reports • Conclusions • Our preliminary data indicate that the majority of the • US detected ‘polypoid lesions’ are incidental findings and are not • true epithelial polyps. • The majority of patients with pre-operative diagnosis of • symptomatic polyps had cholelithiasis on post-operative • histology. • The current management strategy of asymptomatic gallbladder • polyps relies on its size and hence must be included in the radiology reports. • All patients with polyp’s size greater than 10mm should offered • surgery. • Small (<10mm) asymptomatic gallbladder polyps need better • characterization by MRI or EUS. • Long term follow up of non-operated patients is necessary to • allow better understanding of this pathological entity. • Results • 5594 consecutive ultrasound reports were obtained from the • radiology department computerized database. All scans were • performed by trained ultrasonographers. • US-detectedgallbladder polyps were reported in 185 patients • (72 males & 113 females) with an age range of 16 – 59 years • ( Median age of 47 years). • The majority of polyps were detected • incidentally during the workup of • conditions other than suspected • gall bladder one (Fig. 2). Fig 2. Clinical presentation