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Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Nov 28, 2008; 14(44): 6831-6834
Published online Nov 28, 2008. doi: 10.3748/wjg.14.6831
Pre-operative predictive factors for gallbladder cholesterol polyps using conventional diagnostic imaging
Ji-Hoon Choi, Jung-Won Yun, Yong-Sung Kim, Eun-A Lee, Sang-Tae Hwang, Yong-Kyun Cho, Hong-Joo Kim, Jung-Ho Park, Dong-Il Park, Chong-Il Sohn, Woo-Kyu Jeon, Byung-Ik Kim, Hyoung-Ook Kim, Jun-Ho Shin
Ji-Hoon Choi, Jung-Won Yun, Yong-Sung Kim, Eun-A Lee, Sang-Tae Hwang, Yong-Kyun Cho, Hong-Joo Kim, Jung-Ho Park, Dong-Il Park, Chong-Il Sohn, Woo-Kyu Jeon, Byung-Ik Kim, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 110-746, South Korea
Hyoung-Ook Kim, Jun-Ho Shin, Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 110-746, South Korea
Author contributions: Kim HO, Shin JH, Kim HJ and Cho YK designed the research; Kim YS and Lee EA performed the research; Yun JW, Hwang ST, Park JH, Park DI, Sohn CI, Jeon WK, and Kim BI analyzed the data; Choi JH and Cho YK wrote the paper and both should be considered as first authors.
Supported by IN-SUNG Foundation for medical research
Correspondence to: Yong-Kyun Cho, MD, PhD, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 110-746, South Korea. choyk2004@hanmail.net
Telephone: +82-2-2001-2080 Fax: +82-2-2001-2610
Received: January 25, 2008
Revised: May 15, 2008
Accepted: May 22, 2008
Published online: November 28, 2008
Abstract

AIM: To determine the clinical data that might be useful for differentiating benign from malignant gallbladder (GB) polyps by comparing radiological methods, including abdominal ultrasonography (US) and computed tomography (CT) scanning, with postoperative pathology findings.

METHODS: Fifty-nine patients underwent laparoscopic cholecystectomy for a GB polyp of around 10 mm. They were divided into two groups, one with cholesterol polyps and the other with non-cholesterol polyps. Clinical features such as gender, age, symptoms, size and number of polyps, the presence of a GB stone, the radiologically measured maximum diameter of the polyp by US and CT scanning, and the measurements of diameter from postoperative pathology were recorded for comparative analysis.

RESULTS: Fifteen of the 41 cases with cholesterol polyps (36.6%) were detected with US but not CT scanning, whereas all 18 non-cholesterol polyps were observed using both methods. In the cholesterol polyp group, the maximum measured diameter of the polyp was smaller by CT scan than by US. Consequently, the discrepancy between those two scanning measurements was greater than for the non-cholesterol polyp group.

CONCLUSION: The clinical signs indicative of a cholesterol polyp include: (1) a polyp observed by US but not observable by CT scanning, (2) a smaller diameter on the CT scan compared to US, and (3) a discrepancy in its maximum diameter between US and CT measurements. In addition, US and the CT scan had low accuracy in predicting the polyp diameter compared to that determined by postoperative pathology.

Keywords: Cholesterol; Polyps; Gallbladder; Computed tomography; Ultrasonography