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Natural history of small gallbladder polips is benign. Evidence from a clinical and pathogenetic study
- Publication Year :
- 2009
-
Abstract
- Little is known about the natural history and pathogenesis of small gallbladder polyps (10 mm, usually of the cholesterol type), particularly in Western populations. It is unclear if these polyps and gallstones represent different aspects of the same disease. The aim of this study was to characterize the natural history and pathogenesis of small gallbladder polyps.Fifty-six Caucasian patients with small gallbladder polyps, 30 matched gallstone patients, and 30 controls were enrolled in this 5-year prospective study. Patients underwent a symptomatic questionnaire, abdominal ultrasonography, and ultrasonographic evaluation of gallbladder motility at baseline and yearly intervals for 5 years. Cholesterol saturation index, cholesterol crystals in bile, and apolipoprotein E genotype were also determined.Most patients with polyps (mean size: 5.3 mm) were men (61%), asymptomatic, and had multiple polyps (57%). Polyps did not change in 91% of patients during follow-up. No subject experienced biliary pain or underwent cholecystectomy; four developed gallstones. Cholesterol saturation index was higher in patients with polyps or gallstones than in controls (P0.05). Cholesterol crystals were more frequent in patients with polyps than in controls (P0.0001) but less common than in gallstone patients (P0.0001). Polyps and gallstones were associated with nonapolipoprotein E4 phenotypes.The natural history of small gallbladder polyps was benign, as no patient developed specific symptoms and/or morphological changes in polyps. Consequently, a "wait and see" policy is advisable in these patients. Polyps have some pathogenetic mechanisms in common with gallstones, but few patients developed gallstones.
- Subjects :
- Adult
Enoxacin
Male
medicine.medical_specialty
Gallbladder Emptying
GALLSTONES
MEDLINE
Gallbladder Diseases
Gastroenterology
Apolipoproteins E
Polyps
ULTRASONOGRAPHY
Internal medicine
otorhinolaryngologic diseases
medicine
Bile
Humans
GALLBLADDER MOTILITY
BILIARY SECRETION
neoplasms
Hepatology
business.industry
Gallbladder
General surgery
pathological conditions, signs and symptoms
Middle Aged
digestive system diseases
Natural history
Cholesterol
surgical procedures, operative
medicine.anatomical_structure
Small gallbladder
Female
business
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....aeee3ca6fe005254d63891b489cd7a8e