Gallbladder Polyps on Abdominal Ultrasound: Why Bother?

SST08-04

Gallbladder Polyps on Abdominal Ultrasound: Why Bother?

Scientific Papers

Presented on December 2, 2005
Presented as part of SST08: Gastrointestinal (Ultrasound: Miscellaneous)

Bettina Siewert, Presenter: Nothing to Disclose

Maryellen Sun MD, Abstract Co-Author: Nothing to Disclose

Jonathan Bruce Kruskal, Abstract Co-Author: Nothing to Disclose

Robert Alan Kane MD, Abstract Co-Author: Nothing to Disclose

To investigate the significance of gallbladder polyps noted on abdominal ultrasound(US)and to establish whether follow-up imaging is warranted.

We performed a word search of our database for US examinations of the abdomen performed from January-December 1999 for ˜gallbladder polyp˜. Cases were correlated with US follow-up, surgical findings and clinical follow-up. US follow-up examination were compared to the initial examination as to number of polyps, size and additional findings such as stones.

117 cases were included in this study (72 female, 45 male, mean age 51±13 years). 75 had single polyps, 42 had multiple polyps (mean size=5.2±2.3mm, range 2-11mm). 14 patients had additional findings such as cholelithiasis (n=13) or adenomyomatosis (n=1). Follow-up consisted of US (n=51), US and surgery (n=5), surgery only (n=4), clinical follow-up only (n=57). 56 patients had 101 follow=up US examinations (mean follow-up interval 3.2±1.8 years, range 1-6years): 1 (n=33), 2 (n=13), 3 (n=5), 4 (n=2), 5 (n=1), 7 (n=2). Follow-up US revealed: no change in number and size of polyps (n=32), resolution of polyps with normal appearing gallbladder (n=10), cholelithiasis only (n=7), increase in size or number of polyps (n=4), decrease in size or number (n=3). Three of four patients with increase in number of polyps ≤5mm underwent continued follow-up. One patient with increase in size of a polyp from 9 to 15mm underwent surgery which revealed cholelithiasis only. On surgical pathology cholecystitis was present in all patients (n=9). There were no polyps in 6 patients (4 of which had stones), cholesterolosis was present in 2 and polyps were confirmed in one patient. On clinical follow-up of the remaining 57 patients no gallbladder related disease was diagnosed within the follow-up period of 1-6 years (mean follow-up interval 4.2±1.7years).

Gallbladder polyps £11mm in size are likely of no clinical significance and follow-up imaging is not necessary. 23% of polyps resolve or decrease in size on follow-up examination. 13% of lesions initially diagnosed as polyps represent stones on follow-up imaging or surgery.