Cholecystectomy is recommended for suspicious gallbladder polyps to facilitate early detection and treatment. Risk factors for cancer include:
Polyp larger than 1 cm
Primary sclerosing cholangitis
Presence of a single polyp
Patient older than 50 years
Cholesterol polyps account for around half of all polypoid lesions of the gallbladder. These lesions are thought to originate from a defect in cholesterol metabolism. They appear as yellow spots on the mucosal surface of the gallbladder and are identified histologically as epithelial-covered macrophages laden with triglycerides and esterified sterols in the lamina propria of the mucosal layer of the gallbladder. As a rule, cholesterol polyps exist as multiple lesions and are usually smaller than 10 mm. They are generally asymptomatic.
Gallstones are present in most gallbladder cancer cases; however, an etiologic influence remains unproven. Risk factors of developing gallbladder cancer include the inflammatory conditions listed above, advanced age (> 50 years), and the presence of a gallstone larger than 3 cm. Anomalous pancreatobiliary junction also may be a risk factor for gallbladder cancer.
Percutaneous CT-guided biopsy is avoided in patients whose tumors are considered resectable on the basis of preoperative imaging. Because of the substantial risk for peritoneal seeding, percutaneous biopsy and diagnostic cholecystectomy are not necessary in patients suspected of having gallbladder cancer. In these patients, exploration with curative intent is planned on the basis of preoperative imaging alone.
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Cite this: B.S. Anand. Fast Five Quiz: Gallbladder Disease - Medscape - Dec 08, 2021.