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Evaluation of the histopathological analysis and surgical indication of the gallbladder polyps determined by ultrasonography

Gallbladder polyps (GBP) usually originated from the gallbladder mucosa and are structures that show an intraluminal growing pattern (1). Many of them are asymptomatic and detected incidentally during the abdominal or hepatobiliary ultrasound examination. The incidence is detected as 0.3-12 % in healthy people (2) and only 5% of these cases are classified as a true polyp (3). The coexistence frequency of GBP and gallbladder stones 4-8% (4). GBPs are divided into two groups as true polyps and pseudopolyps. Pseudopolyps are composed of cholesterol polyps, inflammatory polyps, hyperplastic polyps, and focal adenomyosis. On the other hand, the true polyp group is adenomatous polyps and adenocarcinomas. The true polyps have a 5-10% of potential to develop malignancy (5). In the case of detection of malignity in polyps, it is called as gallbladder cancer and thisis usually adenocarcinoma (6). Although gallbladder cancer is seen rarely, it is the 5th most commonly seen cancer in the gastrointestinal system (7). The prognosis is remarkably bad, however, the cholecystectomy as surgical management is usually adequate treatment in case of detection at the early stage (T1a) (8). Currently management of GBP's is; monitor the polyps under 6 mm, annually and polyps between 6-9 mm at 6-month intervals, and if there is a growth of 2 mm or more in polyp size between 2 controls, or polyp size reaches 10 mm or above, cholecystectomy is recommended. In addition, if the size of the polyp is over 10 mm at the first diagnosis and the patient is medical fit, again cholecystectomy is recommended. (9) The unnecessary operations performed for GBP may not be cost-effective and create morbidity and mortality however, the patients who are not operated by mistake and need an operation may evolve a potential risk of malignancy. For this reason, the management of GBPs carries significant importance. Although the ultrasound ABSTRACT