Dysplasia in Gallbladder: What Should We Do?

Incidentally detected gallbladder dysplasia in a cholecystectomy specimen, without any gross abnormality, has almost no risk of a hidden invasive carcinoma. Although cholecystectomy is sufficient treatment for gallbladder dysplasia, in our study cohort, 18.9% of cases with incidental dysplasia in gallbladder had an associated pancreatobiliary carcinoma, which supports the hypothesis of multifocal neoplastic potential in the pancreatobiliary tree (also known as field effect). Although follow-up on 16 cases shows no subsequent development of any other pancreatobiliary neoplasm, this number is probably not enough to rule out a serial imaging follow-up of patients who have reported dysplasia in their gallbladder, to assess for subsequent development of neoplasia elsewhere in the pancreaticobiliary tree.