Brief Reports
Copyright ©2005 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Apr 14, 2005; 11(14): 2171-2173
Published online Apr 14, 2005. doi: 10.3748/wjg.v11.i14.2171
Outcome of gall bladder polypoidal lesions detected by transabdominal ultrasound scanning: A nine year experience
D Chattopadhyay, R Lochan, S Balupuri, BR Gopinath, KS Wynne
D Chattopadhyay, R Lochan, S Balupuri, Hepatopancreato-biliary Surgery Unit, Freeman Hospital, Newcastle upon Tyne, NE30PL, UK
BR Gopinath, KS Wynne, Department of Surgery, South Tyneside District Hospital, South Shields, NE34 0PL, UK
Author contributions: All authors contributed equally to the work.
Correspondence to: R Lochan, HPB Unit, Department of Surgery (level 4 Secretaries Office), Freeman Hospital, Newcastle upon Tyne, NE34 0PL, UK. rajiv.lochan@nuth.northy.nhs.uk
Telephone: +44-191-2448427 Fax: +44-191-2231483
Received: August 18, 2004
Revised: August 20, 2004
Accepted: October 5, 2004
Published online: April 14, 2005
Abstract

AIM: To determine the outcome of polypoidal lesions within the gall bladder (PLG) diagnosed by trans-abdominal scanning.

METHODS: A nine-year (1993-2002) retrospective case-note review of all patients who underwent ultrasound scanning after referral to a single Upper GI Surgeon at a District General Hospital was conducted. Patients who were diagnosed with a PLG were included in our study. A database was constructed and patient details, investigations including ultrasound scan (USS) findings, treatment and histology and final diagnosis were recorded.

RESULTS: Twenty-three (out of 651) patients were diagnosed pre-operatively by USS to have a polyp-like gall bladder lesion (PLG). Post cholecystectomy histological examination revealed 12 gallstones, 7 cholesterol polyps, 3 adenocarcinomas within polyps and 1 normal gall bladder. The specificity of USS in the diagnosis of PLG was 92.3%. All the true polyps were malignant. Overall USS had 66.66% sensitivity and 100% specificity in the pre-operative suspicion of malignancy. Using size greater than 10 mm as measured on USS as a cut-off, we find 100% sensitivity and 86.95% specificity with a positive predictive value of 50% in the diagnosis of malignancy in PLG.

CONCLUSION: A large number of PLG are in fact calculi within diseased gall bladder. In cases of gall bladder polyps more then 10 mm in size on USS further imaging (cross-sectional and/or EUS) is indicated prior to surgery. This will help in the optimal management of patients and avoid histological surprises.

Keywords: Polypoidal lesion in gall bladder; Malignant polyps