Efficacy and safety of ultrasound-guided radiofrequency ablation versus laparoscopic cholecystectomy in gallbladder polyps: a bicentric study

The long-term efficacy of ultrasound-guided radiofrequency ablation (RFA) and laparoscopic cholecystectomy (LC) for patients with gallbladder polyps remains uncertain. This study aimed to compare the efficacy and safety of RFA and LC in patients with gallbladder polyps. In this retrospective study, we included 160 patients who underwent treatment for gallbladder polyps at two Chinese medical centres from May 2021 to May 2023, with 79 cases in the RFA group and 81 cases in the laparoscopic cholecystectomy (LC) group. The lesion disappearance rates of RFA group were 83.5%, 89.9%, 94.9%, 97.5% and 100.0% at 1 week, 1 month, 3 months, 6 months and 1-year after ablation, respectively. In the RFA group, no statistically significant difference was observed in the diameter of non-target lesions between the preoperative measurements and those taken at any postoperative follow-up (all P > 0.05). There was no statistically significant difference in gallbladder contraction rate and gallbladder wall thickness before and after ablation (P > 0.05). Postoperative ALT and AST levels were significantly higher, while TP levels were lower, in the LC group compared to the RFA group (all P < 0.05). The differences in hospital stay, operative time, postoperative anal exhaust time, postoperative eating time, and NRS scores on the first postoperative day were also statistically significant (all P < 0.05). The incidence of complications and treatment costs between the two groups did not show statistically significant differences (P > 0.05). Compared with the RFA group, the LC group showed a higher incidence of abdominal pain, abdominal distension, diarrhea, bile reflux gastritis, and malabsorption at 1-year postoperatively (all P < 0.05). Sessile polyps were at higher risk for bile leakage than pedunculated polyps in the RFA group (P = 0.038). In conclusion, ultrasound-guided RFA of gallbladder polyps can effectively inactivate the polyps while preserving the gallbladder, representing a safe, effective, and feasible alternative to LC.