The management of gallbladder polyps
Document type :
Article dans une revue scientifique: Article original
PMID :
Permalink :
Title :
The management of gallbladder polyps
Author(s) :
Valibouze, Caroline [Auteur]
Service de Néphrologie et Transplantation rénale [CHRU-lille]
El Amrani, Mehdi [Auteur]
Miniaturisation pour la Synthèse, l'Analyse et la Protéomique (MSAP) - USR 3290
Miniaturisation pour la Synthèse, l'Analyse et la Protéomique (MSAP) - USR 3290
Service de Néphrologie et Transplantation rénale [CHRU-lille]
Truant, S. [Auteur]
Service de Néphrologie et Transplantation rénale [CHRU-lille]
Leroy, C. [Auteur]
Service Endocrinologie, diabétologie, maladies métaboliques et nutrition [LILLE - Endocrino]
Millet, G. [Auteur]
Service de Néphrologie et Transplantation rénale [CHRU-lille]
Pruvot, F. R. [Auteur]
Service de Néphrologie et Transplantation rénale [CHRU-lille]
Zerbib, P. [Auteur]
Service de Néphrologie et Transplantation rénale [CHRU-lille]
Service de Néphrologie et Transplantation rénale [CHRU-lille]
El Amrani, Mehdi [Auteur]
Miniaturisation pour la Synthèse, l'Analyse et la Protéomique (MSAP) - USR 3290
Miniaturisation pour la Synthèse, l'Analyse et la Protéomique (MSAP) - USR 3290
Service de Néphrologie et Transplantation rénale [CHRU-lille]
Truant, S. [Auteur]
Service de Néphrologie et Transplantation rénale [CHRU-lille]
Leroy, C. [Auteur]
Service Endocrinologie, diabétologie, maladies métaboliques et nutrition [LILLE - Endocrino]
Millet, G. [Auteur]
Service de Néphrologie et Transplantation rénale [CHRU-lille]
Pruvot, F. R. [Auteur]
Service de Néphrologie et Transplantation rénale [CHRU-lille]
Zerbib, P. [Auteur]
Service de Néphrologie et Transplantation rénale [CHRU-lille]
Journal title :
Journal of Visceral Surgery
Abbreviated title :
J Visc Surg
Publication date :
2020-05-27
ISSN :
1878-7886
Keyword(s) :
Laparoscopy
Cholecystectomy
Gallbladder
Polyp
Cancer
Cholecystectomy
Gallbladder
Polyp
Cancer
HAL domain(s) :
Sciences du Vivant [q-bio]
English abstract : [en]
Neoplastic gallbladder polyps (NGP) are rare; the prevalence in the overall population is less than 10%. NGP are associated with a risk of malignant degeneration and must be distinguished from other benign gallbladder ...
Show more >Neoplastic gallbladder polyps (NGP) are rare; the prevalence in the overall population is less than 10%. NGP are associated with a risk of malignant degeneration and must be distinguished from other benign gallbladder polypoid lesions that occur more frequently. NGP are adenomas and the main risk associated with their management is to fail to detect their progression to gallbladder cancer, which is associated with a particular poor prognosis. The conclusions of the recent European recommendations have a low level of evidence, based essentially on retrospective small-volume studies. Abdominal sonography is the first line study for diagnosis and follow-up for NGP. To prevent the onset of gallbladder cancer, or treat malignant degeneration in its early phases, all NGP larger than 10mm, or symptomatic, or larger than 6mm with associated risk factors for cancer (age over 50, sessile polyp, Indian ethnicity, or patient with primary sclerosing cholangitis) are indications for cholecystectomy. Apart from these situations, simple sonographic surveillance is recommended for at least five years; if the NGP increases in size by more than 2mm in size, cholecystectomy is indicated. Laparoscopic cholecystectomy is possible but if the surgeon feels that the risk of intra-operative gallbladder perforation is high, conversion to laparotomy should be preferred to avoid potential intra-abdominal tumoral dissemination. When malignant NGP is suspected (size greater than 15mm, signs of locoregional extension on imaging), a comprehensive imaging workup should be performed to search for liver extension: in this setting, radical surgery should be considered.Show less >
Show more >Neoplastic gallbladder polyps (NGP) are rare; the prevalence in the overall population is less than 10%. NGP are associated with a risk of malignant degeneration and must be distinguished from other benign gallbladder polypoid lesions that occur more frequently. NGP are adenomas and the main risk associated with their management is to fail to detect their progression to gallbladder cancer, which is associated with a particular poor prognosis. The conclusions of the recent European recommendations have a low level of evidence, based essentially on retrospective small-volume studies. Abdominal sonography is the first line study for diagnosis and follow-up for NGP. To prevent the onset of gallbladder cancer, or treat malignant degeneration in its early phases, all NGP larger than 10mm, or symptomatic, or larger than 6mm with associated risk factors for cancer (age over 50, sessile polyp, Indian ethnicity, or patient with primary sclerosing cholangitis) are indications for cholecystectomy. Apart from these situations, simple sonographic surveillance is recommended for at least five years; if the NGP increases in size by more than 2mm in size, cholecystectomy is indicated. Laparoscopic cholecystectomy is possible but if the surgeon feels that the risk of intra-operative gallbladder perforation is high, conversion to laparotomy should be preferred to avoid potential intra-abdominal tumoral dissemination. When malignant NGP is suspected (size greater than 15mm, signs of locoregional extension on imaging), a comprehensive imaging workup should be performed to search for liver extension: in this setting, radical surgery should be considered.Show less >
Language :
Anglais
Audience :
Internationale
Popular science :
Non
Administrative institution(s) :
CNRS
Université de Lille
Université de Lille
Collections :
Submission date :
2021-07-06T12:48:21Z
2024-01-29T13:44:30Z
2024-01-29T13:44:30Z