Is it necessary to perform prophylactic cholecystectomy for asymptomatic subjects with gallbladder polyps and gallstones?
OBJECTIVE
The purpose of the present study was to determine the clinical characteristics of subjects with gallbladder polyps and cholelithiasis compared with those with gallbladder polyps only.


METHODS
Between August 1999 and December 2005, 176 subjects with gallbladder polyps and cholelithiasis (study group) by transabdominal ultrasonography performed during a medical check-up at our institution were recruited and compared with a control group of 185 subjects who had gallbladder polyps only.


RESULTS
No significant difference in the mean interval change (delta) of polyp size during the follow-up period between the study and control groups (0.85 +/- 1.39 mm vs 0.84 +/- 1.58 mm, respectively, P = 0.927) was noted. A significantly higher proportion (9/176 [5.1%]) of examinees in the study group had attacks of acute cholecystitis compared with the control group (1/185 [0.5%], P < 0.01). By multivariate logistic regression analysis, gallbladder wall thickening on initial ultrasonography (odds ratio, 13.7; 95% confidence interval, 1.1-178.0; P = 0.046) and the interval increase in the size of the gallbladder polyps (odds ratio, 14.7; 95% confidence interval, 1.7-126.9; P = 0.014) were independent risk factors for cholecystectomy. No gallbladder cancer occurred during the follow-up period.


CONCLUSIONS
There was no significant difference in delta polyp size between the examinees with gallbladder polyps and cholelithiasis and those with gallbladder polyps only. Hence, a small proportion of subjects with gallbladder polyps and cholelithiasis, such as those with thickened gallbladder walls and an interval increase in the size of the gallbladder polyps are candidates for prophylactic cholecytectomy.
Choi
Sung Youn
SY
Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University College of Medicine, Seoul, Korea.
Kim
Tae Sun
TS
Kim
Hong Joo
HJ
Park
Jung Ho
JH
Park
Dong Il
DI
Cho
Yong Kyun
YK
Sohn
Chong Il
CI
Jeon
Woo Kyu
WK
Kim
Byung Ik
BI
D000328:Adult; D002763:Cholecystectomy / Q000379:methods*; D016001:Confidence Intervals; D003657:Decision Making; D003718:Denmark / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D005706:Gallbladder Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D042882:Gallstones / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D008297:Male; D016017:Odds Ratio; D011127:Polyps / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D015995:Prevalence; D012189:Retrospective Studies