Gallbladder polyps are elevated lesions projecting into the gallbladder lumen. The document outlines the definition, types, epidemiology, studies, and conclusion regarding gallbladder polyps and the need for cholecystectomy. The prevalence of gallbladder polyps is reported between 2-12% in the general population. Size is an important factor, as polyps greater than 1cm carry a risk of malignancy and are an indication for cholecystectomy.

2. Gallbladder polyp >= 1cm
Is cholecystectomy necessary ?

3. Outlines
•Definition
•Types
•Epidemiology
•Studies
•Conclusion

4. Definition
Gallbladder polyps, defined as elevated (mucosal) lesions projecting
into the lumen of the gallbladder.
Christensen AH, Ishak KG (1970) Benign tumors and pseudotumors of the gallbladder. Report of 180 cases.
Arch Pathol 90(5):423–432

5. Types
Benign Malignant
1.Pseudotumors
• Cholesterol polyps(60 – 70 %)
• Inflammatory polyps(10%)
• Cholesterolosis
• Hyperplasia
2.Adenomas(20 %)
3.Mesenchymal tumors
• Lipoma
• Fibroma
• Hemangioma
Ljubičić N, Zovak M, Doko M, Vrkljan M, Vide L. Management of gallbladder polyps: an optimal strategy proposed. Acta Clin
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6. Epidemiology
The prevalence of gallbladder polyps was reported as 4.3–6.9% in
general population
The prevalence of polypoid lesions of the gall bladder are reported in
2–12% of cholecystectomy specimens
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Kwon W, Jang JY, Lee SE, Hwang DW, Kim SW. Clinicopathologic features of polypoid lesions of the gallbladder and risk
factors of gallbladder cancer. J Korean Med Sci. 2009;24:481–7.

7. The age at the time of diagnosis was 49 years
The sex ratio and age at the time of diagnosis of gallbladder polyps
was 1.15 to 1 (male to female)
Park JY, Hong SP, Kim YJ, Kim HJ, Kim HM, Cho JH, et al. Long-term follow up of gallbladder polyps. J Gastroenterol
Hepatol.
Choi JH, Yun JW, Kim YS, Lee EA, Hwang ST, Cho YK, et al. Pre-operative predictive factors for gallbladder cholesterol
polyps using conventional diagnostic imaging. World J Gastroenterol. 2008;14:6831–4.

8. Low prevalence of malignancy
If malignant its notorious malignancy
So how to stratify the risk with gallbladder polyp

9. Risk factors for gallbladder polyp malignancy
• Age and gender of patient
• Ethnicity of patient
• No of polyp
• Presence of gallstone
• Presence of symptoms
• Associated PSC
• Size of polyp

10. Size of polyp
>/= 10mm operation required
?

11. Since up to 50% of polyps more
than 1 cm in diameter carry
carcinoma, patients should
undergo cholecystectomy.
Myers RP, Shaffer EA, Beck PL. Gallbladder polyps:
epidemiology, natural history and management.
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12. Preoperative ultrasound findings with pathological examination of
cholecystectomy specimens in Western patients suggests that size is the
only reliable indicator for malignant potential, with all malignancies found
in polyps greater than 6 mm
Zielinski MD, Atwell TD, Davis PW, Kendrick ML, Que FG
(2009) Comparison of surgically resected polypoid lesions
of the gallbladder to their pre-operative ultrasound
characteristics. J Gastrointest Surg 13:19–25

14. Conclusion
• Prevalence of gallbladder polyp is high in general population.
• Gallbladder polyp associated with risk of carcinoma.
• Many associated risk factors for cagb in gb polyp.
• Size of the polyp is one of the important factor
Gb polyp >/= 1cm is indication for cholecystectomy