The clinico-morphological study of polypoid lesion of the gallbladder and its surgical treatment

• Published in: Tando Vol. 10; no. 4; pp. 305 - 311
• Main Authors: FUTAGAWA, Shunji, SUZUKI, Kunimi, ARIYAMA, JO, BEPPU, Tomoe
• Format: Journal Article
• Language: Japanese
• Published: Japan Biliary Association 1996
• Subjects: 胆嚢ポリープ; 胆嚢小隆起性病変; 胆嚢癌; 腹部CT; 血管造影
• ISSN: 0914-0077; 1883-6879
• DOI: 10.11210/tando1987.10.4_305

One hundred and twelve polypoid lesions of the gallbladder with diameters of less than 20 mm were surgically resected. A comparative study was performed on the shape, pathohistology, computer tomography (CT), angiography, and surgical treatment of these lesions. The cases were histologically clarified to be 8 carcinomas (7.1%),87 cholesterol polypi (77.7%),9 adenomas (8.0%),5 hyperplastic polypi, and 3 inflammatory polypi. One case (1.8%) with lesions of less than 5mm in diameter was carcinoma. Two cases (5.4%) with 6-10 mm diameter lesions, two cases (14.3%) with 11-15 mm diameter lesions, and three cases (75%) with 16-20 mm diameter lesions were carcinoma. All carcinomatous lesions with diameters of 10 mm or under were pedunculated, and limited to the mucosal layer. Only one among 5 carcinomas with a diameter of 11 mm or larger was pedunculated, and this was also limited to the mucosal layer. The other 4 were non-pedunculated with one invading into the proper muscle and the other three into the subserosal layer. Lesions showing positive contrast enhancement of CT and tumor stain at angiography were found to be carcinoma or adenoma. In conclusion, if a small pedunculated polypoid lesion of the gallbladder is found to be cancer, it is most likely limited to the mucosal layer, and laparoscopic cholecystectomy (LC) is indicated for its treatment. A non-pedunculated lesion with a diameter of 11 mm or larger which shows positive contrast enhancement of CT or angiographic tumor stain, is very likely to invade beyond the proper muscle layer, and laparotomy is indicated for this type.