Abstract
We report here our preliminary experience with percutaneous endoscopic polypectomy
of gallbladder polyps. Five patients with a total of 17 cholesterol polyps (size:
4-6 mm) and one patient with two gallbladder adenomas (size: 5 mm), four of whom were
symptomatic and all of whom refused cholecystectomy, underwent a single-stage procedure
under epidural anesthesia. All patients had functioning gallbladders, as assessed
by oral cholecystography after stimulation. Following a small incision, the gallbladder
was pulled out of the abdominal wall, incised, and a cholecystoscope introduced. The
polyps were coagulated at their stalk using microwave irradiation (70-80 mA, 9 sec)
and removed for histopathological evaluation thereafter. A catheter was left in situ
for ten days. Follow-up for a mean of 11.6 months (8-16 months) showed all patients
to be symptom-free and without recurrence of polyps on ultrasonography. Gallbladder
function was assessed in five cases by meal-stimulated oral cholecystography, and
in one by hepato-iminodiacetate acid (HIDA) scan and was found to be well preserved.
The preliminary results warrant further evaluation of this method of removing indeterminate
gallbladder polyps.
