Effect of gallbladder polyp size on the prediction and detection of gallbladder cancer
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Effect of gallbladder polyp size on the prediction and detection of gallbladder cancer Kenji Fujiwara1,2 · Atsushi Abe1 · Toshihiro Masatsugu1 · Tatsuya Hirano1 · Masayuki Sada1 Received: 22 May 2020 / Accepted: 16 September 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background Gallbladder polyps are relatively common. Although most gallbladder polyps are benign, some are malignant. Current guidelines state that malignancy should be suspected for polyps ≥ 10 mm in diameter. We clarified the cancer detection rates in accordance with the size distribution of gallbladder polyps, and evaluated the effectiveness of the reported risk factors in predicting malignancy. Methods In this retrospective case–control study, our institutional database was searched to identify patients who underwent laparoscopic cholecystectomy for benign or malignant gallbladder polyps at Sada Hospital, Japan. The chi-squared test was used to analyze the risk factors for malignancy. Results There were 227 protruding gallbladder lesions. The 206 benign polyps had a diameter of 2–21 mm, while the 21 malignant polyps were 7–60 mm. The cancer detection rates were 16.4% for lesions ≥ 10 mm, 55.9% for lesions ≥ 15 mm, and 94.1% for lesions ≥ 20 mm. Of the benign lesions, cholesterol polyps were the most frequent (50–100%) in all size ranges, even in large lesions (≥ 15 mm). The sessile lesion morphology was significantly more frequent in malignant (60%) than benign lesions (3.4%, p
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