In Reply

Letter to the Editor The Treatment of Gallstone Disease by Carsten Gutt, Simon Schläfer, and Frank Lammert in issue 9/2020

Gallstones >3 cm are considered a risk factor for developing gallbladder cancer, because according to the literature the risk is tenfold. Gallstones >1.5 cm that have been present for a long time can also represent a risk (1).

Solitary gallbladder polyps >1 cm have a high probability of being of neoplastic origin. The cancer risk rises to 50% (2).

According to the literature, porcelain gallbladder is also a risk factor for developing gallbladder cancer. The risk is reported to be up to 62% (3).

For detailed information I refer readers to the updated S3 guideline from the German Society of Gastroenterology, Digestive and Metabolic Diseases (DGVS) and the German Society for General and Visceral Surgery (DGAV) for the prevention, diagnostic evaluation, and treatment of gallstones (AWMF registry No. 021/008).

DOI: 10.3238/arztebl.2020.0490b

On behalf of the authors

Prof. Dr. Dr. h.c. Carsten N. Gutt

Klinik für Allgemein-, Visceral-, Thorax- und Gefäßchirurgie,

Klinikum Memmingen

Conflict of interest statement

The authors of both contributions declare that no conflict of interest exists.

References

1. CariatiA, Piromalli E, Cetta F: Gallbladder cancers: associated conditions, histological types, prognosis, and prevention. Eur J Gastroenterol Hepatol 2014; 26: 5562–9

2. Okamoto M, Okamoto H, Kitakara F: Ultrasonic evidence of association of polyps and stones with gallbladder cancer. Am J Gastroenterol 1999; 94: 446–50

3. Stephen AE, Berger DL: Carcinoma in the porcelain gallbladder: a relationship revisited. Surgery 2001; 129:6 99–703

4. Gutt C, Schläfer S, Lammert F: The treatment of gallstone disease. Dtsch Arztebl Int 2020; 117: 148–58