Is cholecystectomy a reasonable treatment option for simple gallbladder polyps larger than 10 mm?

作     者：Hye Yon Park Se Hoon Oh Kwang Hyuck Lee Jong Kyun Lee Kyu Taek Lee 

作者机构：Division of GastroenterologyDepartment of Internal MedicineSamsung medical centerSungkyunkwan University School of Medicine 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2015年第21卷第14期

页      面：4248-4254页

核心收录：

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主　　题：Gallbladder polyp Gallbladder cancer Cholecystecto 

摘      要：AIM: To determine the relevance of the 10-mm size criterion of the generally accepted surgical indication for gallbladder polyps(GBPs).METHODS: We collected data of patients who were confirmed to have GBPs through cholecystectomy at Samsung Medical Center between January 1997 andDecember *** the patients who underwent cholecystectomy for GBP, those with a definite evidence for malignancy such as adjacent organ invasion, metastasis on preoperative imaging studies, polyp larger than 20 mm, absence of preoperative imaging study results, and patients having gallstones were *** retrospectively collected and analyzed information on patient s clinical characteristics, symptoms, ultrasonographic findings, and blood laboratory ***: A total of 836 patients who had undergone cholecystectomy were retrospectively *** hundred eighty patients(93%) had benign polyps, whereas 56 patients(7%) had malignant *** the 56 patients with malignancy, 4 patients(7%) had borderline GBP(10-12 mm) and a patient had small GBP( 10 mm) with T2 *** conducted an ROC curve analysis to verify the 10-mm size criteria(AUC = 0.887, SD = 0.21, P 0.001).In the ROC curve for polyp size and malignancy, sensitivity and specificity of the 10-mm size criterion was 98.2% and 19.6%, *** specificity of the 11-mm and 12-mm size criteria was 44.6% and 56%, respectively, whereas the sensitivity of these two size criteria was *** defined the GBPs of 10 to 12 mm as a borderline-sized GBP, which were found in 411 patients(49%).In this group, there was a significant difference in age between patients with benign and malignant GBPs(47 years vs 60 years, P 0.05).CONCLUSION: GBPs larger than 13 mm need immediate excision whereas for borderline-sized GBPs detected in young patients, careful medical observation can be a rational decision.