Segment IV Approach is Useful for Whole-Layer Laparoscopic Cholecystectomy for Gallbladder Polyps

Background: Whole-layer laparoscopic cholecystectomy (W-LC) has recently been advocated as a total biopsy for potentially malignant neoplasms of the gallbladder; however, it is not an injury-proof procedure. This study reports W-LC using the segment IV approach (technique for securing the whole-layer gallbladder at the medial origin of the cystic plate). Methods: Twenty among twenty-five patients diagnosed with potentially malignant gallbladder polyps underwent this technique. Results: Mostly, W-LC was performed successfully (median operative time 135 min) without intraoperative and postoperative complications. Pathological findings indicated that cholesteric polyps was the most common type ( n =13), followed by adenomatous polyps (25%) and carcinoma in situ (5%). Conclusions: We conclude that the segment IV approach is appropriate for performing total biopsy in patients diagnosed with potentially malignant gallbladder polyps.