HPB SO36 - Diagnostic Accuracy in Detecting Gall Bladder Polyps: A Retrospective Study

Abstract Background Gallbladder polyps are outgrowths of the gallbladder mucosal wall. They are usually found incidentally on ultrasonography or after cholecystectomy, but can lead to symptoms similar to those caused by gallbladder stones1. It is important to differentiate pseudo-polyps (cholesterol, adenomyomatosis, inflammatory, hyperplastic) from true-polyps (adenomas, adenocarcinomas2,3). The vast majority of polyps detected by ultrasound are pseudo-polyps, with no risk of malignancy. Ultrasound has been considered the gold standard for diagnosis,. However, it is limited by several factors4,5. The primary objective of this study is to assess the accuracy of ultrasound in diagnosing true polyps in patients undergoing surgery for this condition. Method Retrospective review carried out on all US scans reporting Gallbladder polyps for patients who underwent cholecystectomy, with additional data from MRI and CT scans. Sample size 44 patients Time period: From 2019 to present. Analysis was done on Excel Inclusion Criteria: Patients who had cholecystectomies with USS results confirming GB polyps, and have histology reports.Patients who had cholecystectomies with USS results confirming GB stones, and polyps as a co-existing pathology, and have histology reports. Results We included 44 patients our study, all had polyps on USS, and elective laparoscopic cholecystectomy, the mean age was 52 Years, and 63.6 % were women. Out of 44 USS patients, 24 (54.5%) showed features of polyps on histopathology. However, only 6 (13.6%) specimens were identified as adenomas. 18 USS showed polyps measuring 10mm or more. The majority (55.6%) were benign pathologies (pseudo-polyps). Interestingly, only 3 showed features of adenomas (16.7%). 22 Patients had multiple USS for surveillance, Histology showed polyps in 12 specimens (54.5%), out of which only 4 were adenomas (18.2%). Conclusion The accuracy of transabdominal ultrasound in diagnosing true polyps is limited. However, the sensitivity to distinguish adenomas slightly increases in larger polyps This low diagnostic accuracy underscores the need for caution among surgeons when making clinical decisions based on ultrasound-detected polyps. The high false positive rate suggests that more diagnostic criteria are necessary to improve the reliability of ultrasound in the diagnosis and screening of polyps, which is crucial to help reduce unnecessary procedures in asymptomatic patients who had negative histology reports postoperatively.