Le lesioni polipoidi della colecisti: indicazioni all’intervento chirurgico [Polypoid lesions of the gallbladder: indications for surgical treatment]

Through the study of a population of 176 patients with polypoid lesions of the gallbladder, our aim was to demonstrate the advantages of ultrasonography in the identification of those cases in which surgical intervention is indicated. From among our patients, specific criteria were used to select 92 patients to submit to cholecystectomy. These criteria were based on a thorough evaluation of the clinical data (patient's age, familiarity, presence of symptoms), and on careful examination of the ultrasonographic images (number and size of lesions, presence of associated cholelithiasis, state of the gallbladder wall). The histological results and the literature data confirmed the validity of our protocol. The risk factors for carcinoma are age (> 60 years), coexistence of gallstone disease, and the size of the lesions (> 10 mm). Therefore, when these risk factors are present, cholecystectomy is justified even in asymptomatic patients.