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Malignancy in elective cholecystectomy due to gallbladder polyps or thickened gallbladder wall: a single-centre experience
Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery in Linköping.
Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Radiology in Linköping.
Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery in Linköping.
Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery in Linköping.ORCID iD: 0000-0003-2172-5310
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2021 (English)In: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, E-ISSN 1502-7708, Vol. 56, no 4, p. 458-462Article in journal (Refereed) Published
Abstract [en]

Introduction Gallbladder cancer is a rare but aggressive malignancy. Surgical resection is recommended for gallbladder polyps >= 10 mm. For gallbladder wall thickening, resection is recommended if malignancy cannot be excluded. The incidence of gallbladder malignancy after cholecystectomy with indications of polyps or wall thickening in the Swedish population is not known. Material/methods A retrospective study was performed at Linkoping University Hospital and included patients who underwent cholecystectomy 2010 - 2018. All cholecystectomies performed due to gallbladder polyps or gallbladder wall thickening without other preoperative malignant signs were identified. Preoperative radiological examinations were re-analysed by a single radiologist. Medical records and histopathology reports were analysed. Results In all, 102 patients were included, of whom 65 were diagnosed with gallbladder polyps and 37 with gallbladder wall thickening. In each group, one patient (1.5% and 2.7% in each group) had gallbladder malignancy >= pT1b.Two (3.1%) and three (8.1%) patients with gallbladder malignancy < T1b were identified in each group. Discussion/conclusion This study indicates that the incidence of malignancy is low without other malignant signs beyond gallbladder polyps and/or gallbladder wall thickening. We propose that these patients should be discussed at a multidisciplinary tumour board. If the polyp is 10-15 mm or if the gallbladder wall is thickened but no other malignant signs are observed, cholecystectomy can be safely performed by an experienced general surgeon at a general surgery unit. If the histopathology indicates >= pT1b, the patient should be referred immediately to a hepatobiliary centre for liver and lymph node resection.

Place, publisher, year, edition, pages
TAYLOR & FRANCIS LTD , 2021. Vol. 56, no 4, p. 458-462
Keywords [en]
Cholecystectomy; gallbladder; polyp; gallbladder wall thickening
National Category
Cancer and Oncology
Identifiers
URN: urn:nbn:se:liu:diva-174202DOI: 10.1080/00365521.2021.1884895ISI: 000618645400001PubMedID: 33590795OAI: oai:DiVA.org:liu-174202DiVA, id: diva2:1537490
Available from: 2021-03-15 Created: 2021-03-15 Last updated: 2022-05-26

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Edholm, David

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Björk, DennisBartholomä, WolfHasselgren, KristinaEdholm, DavidBjörnsson, BergthorLundgren, Linda
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Department of Surgery in LinköpingDepartment of Medical and Health SciencesFaculty of Medicine and Health SciencesDepartment of Radiology in LinköpingDivision of Surgery, Orthopedics and Oncology
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Scandinavian Journal of Gastroenterology
Cancer and Oncology

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