J.Jpn. Surg. Soc.
ISSN 1880-1129

[Abstract] [Full Text PDF] （in Japanese / 1067KB） [Members Only And Two Factor Auth.]

J.Jpn. Surg. Soc.. 83(12): 1429-1436, 1982

Original article

POLYP OF THE GALLBLADDER ; A CLINICAL AND PATHOLOGICAL STUDY

1) Second Department of Surgery, University of Tokyo, Tokyo
2) Department of Surgery, Fujieda City Hospital, Fujieda
3) Department of Surgery, Asahi Chuo Hospital, Asahi

Joji Iseki1), Koki Ushiyama1), Tomoe Beppu1), Mamoru Hiraishi1), Tatsuo Wada1), Mitsuhiro Nishikino2), Yasujiro Koda2), Masakazu Nobori3)

Twenty-two cases with polyp of the gallbladder were studied clinicopathologically. The term “polyp” was defined as a small mucosal protruded lesion with a stalk or constriction. In four of the 22 cases, the polyps were carcinoma in situ, ranged in size from 6 to 14mm, and had thick stalks. Microscopically, they were adenocarcinoma of papillotubular type, associated with adenomatous growth. Seven cases were instances of adenomas, ranged in size from 3 to 9mm. Microscopically, two of them were of tubular type, and the remaining five were of papillary one. Other 11 cases were instances of cholesterol polyps, they were connected to the wall by a very fine, filamentous pedicle, and microscopically composed of aggregates of foamy histiocytes laden with cholesterol. Recent developement of ultrasonography made it possible to detect tiny polyps of the gallbladder, but it was still difficult to diagnose the histological type preoperatively. The probability of a neoplastic polyp was high under the following condition:(1) female, and the size of polyp being larger than 6mm, (2) the stalk of polyp being thick, not filamentous. Surgical procedures should be performed, when the polyp is suspected to be neoplastic. Simple cholecystectomy is indicated for a presumed benign polyp. For a malignant polyp, we would like to perform cholecystectomy with local resection of the gallbladder bed and dissection of the regional lymph nodes.

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