Percutaneous endoscopic polypectomy of gallbladder polyps.
We report here our preliminary experience with percutaneous endoscopic polypectomy of gallbladder polyps. Five patients with a total of 17 cholesterol polyps (size: 4-6 mm) and one patient with two gallbladder adenomas (size: 5 mm), four of whom were symptomatic and all of whom refused cholecystectomy, underwent a single-stage procedure under epidural anesthesia. All patients had functioning gallbladders, as assessed by oral cholecystography after stimulation. Following a small incision, the gallbladder was pulled out of the abdominal wall, incised, and a cholecystoscope introduced. The polyps were coagulated at their stalk using microwave irradiation (70-80 mA, 9 sec) and removed for histopathological evaluation thereafter. A catheter was left in situ for ten days. Follow-up for a mean of 11.6 months (8-16 months) showed all patients to be symptom-free and without recurrence of polyps on ultrasonography. Gallbladder function was assessed in five cases by meal-stimulated oral cholecystography, and in one by hepato-iminodiacetate acid (HIDA) scan and was found to be well preserved. The preliminary results warrant further evaluation of this method of removing indeterminate gallbladder polyps.
Ji
Z L
ZL
Departments of General and Biliary Surgery, Affiliated Hospital, Nanjing Railway Medical College, Jiangsu, China.
Chen
H R
HR
Wang
E H
EH
Yang
D T
DT
Gao
N R
NR
Yang
J Z
JZ
Liu
B Y
BY
D000328:Adult; D002765:Cholecystography; D016145:Endoscopy, Digestive System / Q000379:methods; D005260:Female; D005706:Gallbladder Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008872:Microwaves / Q000627:therapeutic use; D008875:Middle Aged; D011127:Polyps / Q000000981:diagnostic imaging / Q000601:surgery*; D014463:Ultrasonography