27 سنوات
I had an echography today and a polype of 1.3mm was detected inside my visicul biliary (internal surface). Is it serious? How can it be treated?
25 نوفمبر 2014
Approximately 5% of patients evaluated with ultrasound imaging for abdominal pain will have a gallbladder polyp. The causes are not clear, but there is a strong association with increasing age and the presence of gallstones (cholelithiasis). Most affected individuals are symptoms-free.
Most small polyps (less than 1 cm in size) are not cancerous and may remain unchanged for years. The incidence of gallbladder cancer is 1.2 cases 100,000 persons, so it's very rare.
The most common types pf gall bladder polyps include:
1- Benign lesions
Benign lesions of the gallbladder are relatively common, but only adenomatous polyps are considered to have the potential to become cancerous.
2- Cholesterol polyps
Constitute approximately 50% of all polypoid lesions of the gallbladder. These lesions are thought to result from a problem in cholesterol metabolism. Typically, cholesterol polyps exist as multiple lesions and are usually less than 10 mm. Cholesterol polyps are generally asymptomatic.
These lesions occur in the context of chronic inflammation.
4- Adenomyomatosis
Adenomyomatosis is generally considered a benign condition, but serial evaluation with ultrasonography is indicated to rule out enlarging adenomatous polyps and gallbladder cancer.
5- Adenomatous polyps
Adenomatous polyps are benign growths.
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usually if the polype is more then 1cm it is preferable to do laparoscopic cholecystectomy.
Treatment and prognosis
Statistically, gallbladder polyps are common and gallbladder cancer is rare, so very few polyps progress to gallbladder cancer. There is also controversy regarding the development of gallbladder cancer and some suggest that polyps may not actually progress to cancer 10.
Recommended follow-up of small polyps (<10 mm) varies from author to author. A commonly accepted strategy includes:
- ≤5 mm: no further follow up necessary 6,10
- 6-9 mm: follow-up to ensure no interval growth. Follow-up interval varies from 3 to 6 months 6,9
- ≥10 mm: surgical consultation
- usually warrants cholecystectomy
- if no cholecystectomy, annual follow up is warranted 11
Lower thresholds for follow up or intervention may be warranted if one's patient population is known to have a higher risk of gallbladder carcinoma (e.g. higher incidences in Pakistan, Ecuador, or females in India).
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