1887
Volume 2021, Issue 3
  • ISSN: 0253-8253
  • EISSN: 2227-0426

Abstract

Background: Gallbladder (GB) polyps are raised lesions from the GB wall and projected into its lumen. The prevalence of GB polyps ranged between 4.3% and 12.3%. The clinical presentation of GB polypoid lesions vary, can be nonspecific and vague, and may be asymptomatic. Identifying malignant and premalignant polyps is important to provide treatment early and prevent cancer spread or development of malignancy. Ultrasonography (US) is the first imaging modality widely used in abdominal imaging. It is a noninvasive, rapid, painless, and safe imaging technique, with no radiation; thus, it is considered the best available examination with good sensitivity and specificity for GB polyps.

Aim of the work: This study aimed to determine the relative frequency of the GB polyps and its risk factors among patients who underwent abdominal US in Primary Health Care Corporation, Qatar.

Materials and methods: This was quantitative multicenter observational case–control study nested in a cross-sectional design. For the cross-sectional top-level study, the first step was to assess available abdominal ultrasound studies for the presence of GB polyps and stones. The second step was to perform a case–control study with three groups (a case group and two control groups; first, participants without GB stones and GB polyps; second, patients with GB stones but without GB polyps).

Results: The study evaluated the GB images of 7156 individuals. The overall prevalence of GB polyps was 7.4% in the study population. Specifically, the overall prevalence of solitary GB polyp was 4.2% and that of multiple GB polyps was 3.2%. Regarding the size distribution of GB polyps in positive cases, 89.4% were < 6 mm, 9.3% were 69 mm, and 1.3% were ≥ 10 mm. Prevalence rate of selected comorbidities were as follows: liver disease, 1.8%; diabetes mellitus, 25.5%; hypertension, 25.5%; and dyslipidemia, 29.8%. The prevalence in male and female patients was 7.7% and 7%, respectively. The prevalence of GB polyps was higher in south-eastern patients (21.4% of positive cases) and was the highest in the overweight group (8.8%). A higher prevalence was noted in the hypertensive group (hypertensive group, 9.8%; non-hypertensive group, 6.6%) and dyslipidemia group (dyslipidemia group, 7.8%; no dyslipidemia group, 7.2%). Moreover, a higher prevalence was noted in hepatitis B surface (HBS)-positive group (15%) than in the HBS-negative group (8.2%) and slightly higher in antigen positive group than in the negative group.

Conclusion: Abdominal US is an important and commonly used imaging modality in the detection of GB polyps. In this study, the prevalence of GB polyps was approximately 7.4%, with higher prevalence in participants who were overweight and had diabetes mellitus, hypertension, and dyslipidemia.

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2021-10-07
2024-11-05
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References

  1. Choi YS, Do JH, Seo SW, Lee SE, Oh HC, Min YJ, Kang H, . Prevalence and risk factors of gallbladder polypoid lesions in a healthy population. Yonsei Med J. 2016;57:1370–1375.
    [Google Scholar]
  2. Choi JH, Yun JW, Kim YS, Lee EA, Hwang ST, Cho YK, et al, . Pre-operative predictive factors for gallbladder cholesterol polyps using conventional diagnostic imaging. World J Gastroenterol. 2008;14:6831–6834.
    [Google Scholar]
  3. Sandberg AA. Diagnosis and management of gallbladder polyps. North Am J Med Sci. 2012;4:203–2011.
    [Google Scholar]
  4. Matos AS, Baptista HN, Pinheiro C, Martinho F, . Gallbladder polyps: how should they be treated and when? Rev Assoc Med Bras. 2010;56:318–321.
    [Google Scholar]
  5. Stephen RM, Diamond A, Jones C, and Coleman, . HG. Current practices and future prospects for the management of gallbladder polyps: a topical review. World J Gastroenterol. 2018;24:2844–2852.
    [Google Scholar]
  6. Kratzer W, Gräter T, Schmidberger J. Gallbladder polyps – a follow-up study after 11 years. BMC Gastroenterol. 2019:42.
    [Google Scholar]
  7. G. Randi, S. Franceschi, C. La Vecchia, . Gallbladder cancer worldwide: geographical distribution and risk factors. Int. J. Cancer. 2006;118:1591–1602.
    [Google Scholar]
  8. Inui K, Yoshino J, Miyoshi H, . Diagnosis of gallbladder tumors. Intern Med. 2011;50:1133–1136.
    [Google Scholar]
  9. Moriguchi H, Tazawa J, Hayashi Y, et al. Natural history of polypoid lesions in the gallbladder. Gut. 1996;39:860–862.
    [Google Scholar]
  10. Segawa K, Arisawa T, Niwa Y, et al, . Prevalence of gallbladder polyps among apparently healthy Japanese: ultrasonographic study. Am J Gastroenterol. 1992;87:630–633.
    [Google Scholar]
  11. Okamoto M, Okamoto H, Kitahara F, et al. Ultrasonographic evidence of association of polyps and stones with gallbladder cancer. Am J Gastroenterol. 1999;94:446–450.
    [Google Scholar]
  12. Jorgensen T, Jensen KH, . Polyps in the gallbladder. A prevalence study. Scand J Gastroenterol. 1990;25:281-286.
    [Google Scholar]
  13. Pandey M, Khatri AK, Sood BP, et al, . Cholecystosonographic evaluation of the prevalence of gallbladder diseases. A university hospital experience. Clin Imaging. 1996;20:269–272.
    [Google Scholar]
  14. Collett JA, Allan RB, Chisholm RJ, et al, . Gallbladder polyps: prospective study. J Ultrasound Med. 1998;17:207–211.
    [Google Scholar]
  15. Kwon W, Jang JY, Lee SE, Hwang DW, Kim SW, . Clinicopathologic features of polypoid lesions of the gallbladder and risk factors of gallbladder cancer. J Korean Med Sci. 2009;24:481–487.
    [Google Scholar]
  16. Cantürk Z, Sentürk O, Cantürk NZ, Anik YA. Prevalence and risk factors for gallbladder polyps. East Afr Med J. 2007;84:336-341.
    [Google Scholar]
  17. Park JY, Hong SP, Kim YJ, Kim HJ, Kim HM, Cho JH, et al, . Long-term follow up of gallbladder polyps. J Gastroenterol Hepatol. 2009;24:219–222.
    [Google Scholar]
  18. Gallahan WC, Conway JD, . Diagnosis and management of gallbladder polyps. Gastroenterol Clin North Am. 2010;39:359–367.
    [Google Scholar]
  19. Kwon W, Jang JY, Lee SE, Hwang DW, Kim SW, . Clinicopathologic features of polypoid lesions of the gallbladder and risk factors of gallbladder cancer. J Korean Med Sci. 2009;24:481–487.
    [Google Scholar]
  20. Zielinski MD, Atwell TD, Davis PW, Kendrick ML, Que FG, . Comparison of surgically resected polypoid lesions of the gallbladder to their pre-operative ultrasound characteristics. J Gastrointest Surg. 2009;13:19–25.
    [Google Scholar]
  21. Rawla P, Sunkara T, Chaitanya KT, Barsouk A, . Epidemiology of gallbladder cancer. Clin Exp HEPATOL 2019;5:93–102.
    [Google Scholar]
  22. American Cancer Society: Cancer Facts and Figures 2020. Atlanta, Ga: American Cancer Society, 2020. Available online. Last accessed January 17, 2020.
    [Google Scholar]
  23. Miranda AF, Piñeros M, Ferreccio C, Koshiol J, et al. Gallbladder and extrahepatic bile duct cancers in the Americas: incidence and mortality patterns and trends. Intern J Canc 2020. DOI:10.1002/ijc.32863.
    [Google Scholar]
  24. Yamamoto M, Nakajo S, Tahara E, . Histological classification of epithelial polypoid lesions of the gallbladder. Acta Pathol Joun. 1988;38:181–192.
    [Google Scholar]
  25. Ministry of Development Planning and Statistics State Qatar, Qatar Monthly Statistics Report, August 2016, (2016) Doha.
  26. Sulieman I, Elmoghazy W, Ansari W, Elaffandi A, . and Khalaf H. Gallbladder cancer: 7-Year experience from Qatar. Ann Med Surg 2019;44:33–38.
    [Google Scholar]
  27. Bennett, G.L. and Blathazar, E.J. Ultrasound and CT Evaluation of emergent gallbladder pathology. Radiol Clin North Am. 2003;41:1203–1216.
    [Google Scholar]
  28. Escalona A, León F, Bellolio F, Pimentel F, Guajardo M, Gennero R, et al. Gallbladder polyps: Correlation between ultrasonographic and histopathological findings. Rev Med Chil. 2006;134:1237–1242.
    [Google Scholar]
  29. Ito H, Hann LE, D'Angelica M, Allen P, Fong Y, Dematteo RP, et al. Polypoid lesions of the gallbladder: Diagnosis and followup. J Am Coll Surg. 2009;208:570–575.
    [Google Scholar]
  30. Myers RP, Shaffer EA, Beck PL, . Gallbladder polyps: epidemiology, natural history and management. Can J Gastroenterol. 2002;16:187–194.
    [Google Scholar]
  31. Kleinbaum D G., Sullivan K M, Bark N D, 2007. A Pocket Guide to Epidemiology. Springer Science + Business Media, NewYork, USA.).
    [Google Scholar]
  32. World Health Organization. Report of a WHO consultation: definition of metabolic syndrome in definition, diagnosis and classification of diabetes mellitus. World Health Organization, Department of Non-communicable Disease Surveillance, Geneva, 1999.
  33. Pedersen MR, Dam C, Rafaelsen SR, . (2012) Ultrasound follow-up for gallbladder polyps less than 6 mm may not be necessary. Dan Med J. 59:A4503.
    [Google Scholar]
  34. Hong AR, Lim S, . Clinical characteristics of metabolic syndrome in Korea, and its comparison with other Asian countries. J Diabetes Investig. 2015;6:508–515.
    [Google Scholar]
  35. Lee YJ, Park KS, Cho KB, Kim ES, Jang BK, Chung WJ, et al, . Shifting prevalence of gallbladder polyps in Korea. J Korean Med Sci. 2014;29:1247–1252.
    [Google Scholar]
  36. Shim SG, Lee KT, Lee JK, Park JH, Ryu JH, Rhee PL, et al, . Prevalence and risk factors of gallbladder polyps in health screening subjects. Korean J Med. 1999;57:1014–1020.
    [Google Scholar]
  37. Yamin Z, Xuesong B, Zhen Z, Yue H, Liwei L, Li Fei, . F. Correlation of dyslipidemias and gallbladder polyps. A large retrospective study among Chinese population. Asian J Surg. 2020 43,181–185.
    [Google Scholar]
  38. Chen CY, Lu CL, Chang FY, Lee SD, . Risk factors for gallbladder polyps in the Chinese population. Am J Gastroenterol. 1997;92:2066–2068.
    [Google Scholar]
  39. Everson GT. Gallbladder function in gallstone disease. Gastroenterol Clin North Am. 1991;20:85–110.
    [Google Scholar]
  40. Kim SY, Lee HS, Lee YS, Chung KW, Jang BK, Chung WJ, et al, . [Prevalence and risk factors of gallbladder polyp in adults living in Daegu and Gyeongbuk provinces]. Korean J Gastroenterol. 2006;48:344–350.
    [Google Scholar]
  41. Takahashi Y, Yamamichi N, Shimamoto T, Mochizuki S, Fujishiro M, Takeuchi C, et al, . Helicobacter pylori infection is positively associated with gallstones: a large-scale cross-sectional study in Japan. J Gastroenterol. 2014;49:882–9.
    [Google Scholar]
  42. Mishra RR, Tewari M, Shukla HS, . Association of Helicobacter pylori infection with inflammatory cytokine expression in patients with gallbladder cancer. Indian J Gastroenterol. 2013;32:232–235.
    [Google Scholar]
  43. Kubota K, Bandai Y, Noie T, Ishizaki Y, Teruya M, Makuuchi M, . How should polypoid lesions of the gallbladder be treated in the era of laparoscopic cholecystectomy? Surgery. 1995;117:481–487.
    [Google Scholar]
  44. Sheth S, Bedford A, Chopra S, . Primary gallbladder cancer: recognition of risk factors and the role of prophylactic cholecystectomy. Am J Gastroenterol. 2000;95:1402–410.
    [Google Scholar]
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