Pathological and Ultrasonographic Concordance of Gallbladder Polyps Following Cholecystectomy

Introduction: Gallbladder polyps are mucosal projections into the gallbladder lumen, often detected incidentally during ultrasonography or after cholecystectomy. While most are benign, some carry a risk of malignant transformation. This study aimed to evaluate the diagnostic sensitivity of preoperative ultrasonography in detecting gallbladder polyps confirmed by postoperative pathological analysis. Material and Methods: A retrospective review was conducted on patients who underwent cholecystectomy between October 2021 and March 2024 at Erzurum Regional Training and Research Hospital. Pathology reports were examined to identify gallbladder polyps. Patients with malignancy-related surgeries or missing ultrasonography data were excluded. Polyps were classified by size as small (1–5 mm), medium (6–9 mm), and large (≥10 mm). Ultrasonographic findings were compared with pathology results, and data were analyzed using SPSS version 22. Results: Among 3,230 cholecystectomies, 87 patients had gallbladder polyps, and 70 met the inclusion criteria. The mean age was 47.8 years, and the female-to-male ratio was 1.52. Pathologically, 58 patients had small, 5 had medium, and 7 had large polyps. Preoperative ultrasonography identified polyps in only 25 of 56 patients (sensitivity: 45%). Among patients with polyps ≥6 mm (n=11), only 5 were identified preoperatively. For polyps ≥10 mm (n=6), only 2 were correctly detected. Discussion: The sensitivity of ultrasonography for detecting gallbladder polyps in this study was lower than reported in the literature. Particularly concerning was the misdiagnosis of polyps ≥10 mm, which pose a higher risk for malignancy. These findings emphasize the need for heightened vigilance and systematic evaluation in ultrasonographic assessments, especially in high-risk patients.