Clinicopathological Studies of Polypoid Lesions of the Gallbladder

Yoshiaki Murakami, Takashi Yokoyama*, Takashi Kodama, Yoshio Takesue, Mitsuaki Okita, Atsushi Nakamitsu, Yuji Imamura, Takahiro Santo, Hiroaki Tsumura, Katsunari Miyamoto, Yuichiro Matsuura

First Department of Surgery, *Department of General Medicine, Hiroshima University School of Medicine

Clinicopathological studies of 21 patients with polypoid lesions of the gallbladder (6 with adenocarcinoma (AC), 3 with adenoma, 5 with cholesterol polyp (CP), 4 with hyperplastic polyp, 2 with inflammatory polyp and 1 with ectopic gastric mucosa) which were resected in our department in the past five years are reported. Preoperatively, it was difficult to differentiate AC from other disease by ultrasonography (US). Only CP could be diagnosed by US. Most of the patients with AC were elderly and the muximum diameter of all of the polypoid lesions of AC was more than l0 mm. AC was divided into AC in adenoma whose lesions were pedunculated (P type) and advanced AC whose lesions were flat-elevated (F type). F type developed into advanced AC earlier when the maximum diameter of the polypoid lesion was small. All patients with AC are still alive without recurrence. An important factor for good prognosis of AC was that the DNA ploidy patterns of AC were all diploid. We suggest that the indications for surgical treatment of polypoid lesions of the gallbladder are a P type lesion of more than 10 mm and an F type lesion of more than 5 mm, and that total resection of the gallbladder, including lymphnode dissection, choledochectomy and hepatectomy according to the results of frozen sections, should be performed in these cases.

Key words
polypoid lesions of the gallbladder, imaging diagnosis for polypoid lesions of the gallbladder, DNA ploidy pattern, surgical strategy for polypoid lesions of the gallbladder

Reprint requests
Yoshiaki Murakami First Department of Surgery, Hiroshima University School of Medicine
1-2-3 Kasumi, Minami-ku, Hiroshima, 734 JAPAN

Accepted
September 4, 1991

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