Potencial maligno de pólipos vesiculares. Todos têm indicação cirúrgica?

Abstract

Introduction: Gallbladder polyps are mucosal lesions that protrude into the lumen of the gallbladder. In most cases the diagnosis is made incidentally as they are asymptomatic. The presence of polyps is a risk factor for gallbladder cancer. Cholecystectomy is recommended according to the guidelines, leading to unnecessary resection in one third of patients. This study evaluates the malignant potential of gallbladder polyps to verify whether all are indicated for laparoscopic cholecystectomy. Materials and methods: Retrospective observational study of 151 patients diagnosed with gallbladder polyps who underwent cholecystectomy between 2018 and 2022. The prevalence of polyps and gallbladder cancer in this population was assessed and predictive factors for malignancy were characterized using statistical analysis performed with the Statistical Package for the Social Sciences. Results: The 151 participants studied were divided into 84 (55.6%) asymptomatic and 67 (44.4%) symptomatic patients. Pathological anatomy confirmed the presence of polyps in 96 (63.6%) surgical specimens and their absence in 55 (36.4%). Five (3.3%) cases of cancer were identified. In these cases, all were found to be 60 years of age or older; 4 (80%) were male and 1 (20%) was female; all had a history of neoplasms of the gastrointestinal tract and all polyps associated with cancer were between 6 and 9 mm in size. Conclusion: Patients aged 60 years or older, with polyps between 6 and 9 mm and with a history of gastrointestinal neoplasms have a higher risk of developing true polyps and consequently a higher likelihood of developing gallbladder cancer.