Strategy for discriminating cholesterol and premalignancy in polypoid lesions of the gallbladder: a single-centre, retrospective cohort study.
BACKGROUND
The present study aimed to assess the risk factors of cholesterol and premalignancy in polypoid lesions of the gallbladder (PLGs) and to establish an appropriate treatment strategy.


METHODS
Data from patients who underwent cholecystectomy at the First Affiliated Hospital, School of Medicine, Zhejiang University, between January 2011 and July 2017, were collected retrospectively.


RESULTS
A total of 1561 patients were included in the present study. The cohort comprised of 636 (40.7%) males and 925 (59.3%) females, with a mean age of 49.5 (range 16-88) years; 65.6% (1024/1561) demonstrated cholesterol lesions in this cohort, among which cholesterol polyps accounted for 81.0%. Age younger than 50 years and multiple number of polyps were found to be independent predictive variables for cholesterol lesions (odds ratio (OR) 3.461, 95% confidence interval (CI) 2.058-5.820, P < 0.001 and OR 3.321, 95% CI 1.988-5.547, P < 0.001, respectively). The presence of polyp growth was associated with premalignancy (OR 5.366, 95% CI 1.466-19.637, P = 0.011), and the presence of clinical symptoms indicated benign non-cholesterol lesions (OR 0.368, 95% CI 0.153-0.885, P = 0.026).


CONCLUSION
In the case of patients ≥50 years old with single asymptomatic polyp, cholecystectomy was recommended if the polyp presented growth at a rate above 3-4 mm within 6 months. If not, trimonthly ultrasound follow up was recommended, and clinicians should carefully assess the risk factors for premalignancy in PLGs.
['Wu|Tianchun|T|0000-0001-9923-3944', 'Sun|Zhongquan|Z|', 'Jiang|Yuancong|Y|', 'Yu|Jinbei|J|', 'Chang|Chengdong|C|', 'Dong|Xiaogang|X|', 'Yan|Sheng|S|']
D000328:Adult D002763:Cholecystectomy D002784:Cholesterol D005260:Female D005706:Gallbladder Neoplasms D006801:Humans D008297:Male D008875:Middle Aged D011127:Polyps D011230:Precancerous Conditions D011237:Predictive Value of Tests D012189:Retrospective Studies D012307:Risk Factors D014463:Ultrasonography
polypoid lesions of the gallbladder risk factors cholecystectomy cholesterol lesions premalignant lesions