Departments of Pediatric Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Departments of Pediatric Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Turk J Gastroenterol. 2022 Sep;33(9):803-807. doi: 10.5152/tjg.2022.21944.
Gallbladder polyps are rare lesions protruding into the gallbladder lumen with variable clinical presentation. No standard treatment algorithm has been developed for pediatric gallbladders, and the malignant potential of the gallbladder is not clear in children. Therefore, a retrospective study was performed to evaluate the clinical features and treatment options of gallbladder polyps in children.
Between 2014 and 2020, children diagnosed with gallbladder polyps were evaluated for age, gender, clinical features, results of follow-up with ultrasound findings, and treatment options retrospectively.
The records of 15 patients with a mean age of 13.2 years (2-20 years) were included. The male: female ratio was 7 : 8. Gallbladder polyps was detected incidentally in 73.3% (n = 11) of the patients. Four (20%) of the patients were symptomatic (26.7%) and complained about abdominal pain. Laboratory tests were normal except in 3 patients who showed slightly increased liver function tests. Two of the patients had 3 polyps on admission. The polyps were 2-10 mm in size. The size of the polyp increased in 5 patients (33.3%) and disappeared in 4 patients (26.6%) in follow-up ultrasound examinations. Five of the patients underwent cholecystectomy and 1 of them was scheduled for surgery. Five of the asymptomatic patients who have polyps less than 10 mm in size are still on follow-up. In patients with cholecystectomy, the histopathology of gallbladders revealed cholesterol polyps (n = 2) and hyperplastic polyps (n = 2). One of the patients with cholecystectomy showed no polyps in histopathological evaluation.
Despite the lack of a standardized algorithm, our data suggested that multiple polyps, polyps with increased in size or greater than 10 mm, and the presence of symptoms might require cholecystectomy in children. Asymptomatic patients with small-sized polyps can be identified using ultrasound, and the polyps may disappear during the subsequent follow-up.
胆囊息肉是一种罕见的向胆囊腔内突出的病变，其临床表现各异。目前尚未为儿科胆囊制定标准的治疗方案，且儿童胆囊的恶性潜能尚不明确。因此，本研究回顾性分析了儿童胆囊息肉的临床特征和治疗选择。
2014 年至 2020 年期间，我们对经超声检查诊断为胆囊息肉的患儿进行了回顾性分析，评估了其年龄、性别、临床表现、超声随访结果以及治疗选择。
本研究共纳入了 15 例患儿，平均年龄为 13.2 岁（2-20 岁），男女比例为 7:8。73.3%（n=11）的患儿为偶然发现，4 例（20%）患儿出现症状（26.7%），表现为腹痛。除 3 例患儿肝功能检查略有升高外，其余患儿的实验室检查均正常。2 例入院时即存在 3 个息肉，息肉大小为 2-10mm。5 例患儿的息肉大小在随访超声检查中增大（33.3%），4 例患儿的息肉消失（26.6%）。5 例行胆囊切除术，其中 1 例患儿拟行手术治疗。5 例无症状且息肉直径＜10mm 的患儿仍在随访中。行胆囊切除术的患儿中，胆囊组织病理学检查显示胆固醇息肉（n=2）、增生性息肉（n=2），1 例患儿的组织病理学检查未见息肉。
尽管缺乏标准化的治疗方案，但我们的数据表明，对于多发性息肉、息肉增大或直径＞10mm 以及存在症状的患儿，可能需要行胆囊切除术。对于直径较小且无症状的患儿，可以通过超声进行识别，且息肉可能在随后的随访中消失。
