Advances in the management of gallbladder polyps: establishment of predictive models and the rise of gallbladder-preserving polypectomy procedures

Liu, Haoran; Lu, Yongda; Shen, Kanger; Zhou, Ming; Mao, Xiaozhe; Li, Rui

doi:10.1186/s12876-023-03094-7

Cited by 3 publications

(1 citation statement)

References 50 publications

(62 reference statements)

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“…Minimally invasive procedures for polypectomy alone, in which the gallbladder is preserved and is functional, have recently gained increasing interest[ 31 ]. These methods include: (1) Ultrasound-guided radiofrequency for adenoma ablation[ 32 - 34 ]; (2) endoscopic cholecystostomy under ultrasound guidance, which serves as a bridging procedure to endoscopic polypectomy through the gallbladder wall[ 35 , 36 ]; (3) laparoscopic-assisted transumbilical gastroscopy for gallbladder-preserving adenoma resection[ 37 - 39 ]; (4) peroral choledochoscopic gallbladder-preserving adenoma resection[ 40 , 41 ]; and (5) transgastric endoscopic gallbladder preserving surgery[ 42 ].…”

Section: Introductionmentioning

confidence: 99%

Current considerations for the surgical management of gallbladder adenomas

Pavlidis,

Galanis,

Pavlidis

2024

World J Gastrointest Surg

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Gallbladder adenomas are rare lesions (0.5%) associated with potential malignant transformation, particularly with gallbladder adenomas that are ≥ 1 cm in size. Early detection and management are crucial for preventing lethal carcinoma development. These polyps can often be distinguished from the more often nonneoplastic cholesterol pseudopolyps (5%-10%), which are benign. Ultrasonography is the first-line tool for initial diagnosis and follow-up when indicated. The question is whether cholecystectomy is always necessary for all adenomas. The management of gallbladder adenomas is determined according to the size of the tumor, the growth rate of the tumor, the patient’s symptoms and whether risk factors for malignancy are present. Adenomas ≥ 1 cm in size, an age > 50 years and a familial history of gallbladder carcinoma are indications for immediate laparoscopic cholecystectomy. Otherwise, ultrasound follow-up is indicated. For adenomas 6-9 mm in size, the absence of ≥ 2 mm growth at 6 months, one year, and two years, as well as an adenoma sized < 5 mm without existing risk factors indicates that no further surveillance is required. However, it would be preferable to individualize the management in doubtful cases. Novel interventional modalities for preserving the gallbladder need further evaluation, especially to determine the long-term outcomes.

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Section: Introductionmentioning

confidence: 99%

Current considerations for the surgical management of gallbladder adenomas

Pavlidis,

Galanis,

Pavlidis

2024

World J Gastrointest Surg

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Establishing a Preoperative Predictive Model for Gallbladder Adenoma and Cholesterol Polyps Based on Machine Learning: A Multicentre Retrospective Study

Wang,

Qu,

Zeng

et al. 2024

Preprint

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Background With the rising diagnostic rate of gallbladder polypoid lesions (GPLs), differentiating benign cholesterol polyps from gallbladder adenomas with a higher preoperative malignancy risk is crucial. This study aimed to establish a preoperative prediction model capable of accurately distinguishing between gallbladder adenomas and cholesterol polyps using machine learning algorithms. Materials and Methods We retrospectively analysed the patients' clinical baseline data, serological indicators, and ultrasound imaging data. Using 12 machine learning algorithms, 110 combination predictive models were constructed. The models were evaluated using internal and external cohort validation, receiver operating characteristic curves, area under the curve (AUC) values, calibration curves, and clinical decision curves to determine the best predictive model. Results Among the 110 combination predictive models, the Support Vector Machine + Random Forest (SVM + RF) model demonstrated the highest AUC values of 0.972 and 0.922 in the training and internal validation sets, respectively, indicating an optimal predictive performance. The model-selected features included gallbladder wall thickness, polyp size, polyp echo, and pedicle. Evaluation through external cohort validation, calibration curves, and clinical decision curves further confirmed its excellent predictive ability for distinguishing gallbladder adenomas from cholesterol polyps. Additionally, this study identified age, adenosine deaminase level, and metabolic syndrome as potential predictive factors for gallbladder adenomas. Conclusion This study employed the latest machine learning combination algorithms and preoperative ultrasound imaging data to construct an SVM + RF predictive model, enabling effective preoperative differentiation of gallbladder adenomas and cholesterol polyps. These findings will assist clinicians in accurately assessing the risk of GPLs and providing personalised treatment strategies.

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Endoscopic diagnosis and management of gallbladder carcinoma in minimally invasive era: New needs, new models

Deqing,

Zhang,

Yang

2024

World J Gastrointest Oncol

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Gallbladder cancer (GBC) is a rare and lethal malignancy; however, it represents the most common type of biliary tract cancer. Patients with GBC are often diagnosed at an advanced stage, thus, unfortunately, losing the opportunity for curative surgical intervention. This situation leads to lower quality of life and higher mortality rates. In recent years, the rapid development of endoscopic equipment and techniques has provided new avenues and possibilities for the early and minimally invasive diagnosis and treatment of GBC. This editorial comments on the article by Pavlidis et al . Building upon their work, we explore the new needs and corresponding models for managing GBC from the endoscopic diagnosis and treatment perspective.

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Advances in the management of gallbladder polyps: establishment of predictive models and the rise of gallbladder-preserving polypectomy procedures

Cited by 3 publications

References 50 publications

Current considerations for the surgical management of gallbladder adenomas

Current considerations for the surgical management of gallbladder adenomas

Establishing a Preoperative Predictive Model for Gallbladder Adenoma and Cholesterol Polyps Based on Machine Learning: A Multicentre Retrospective Study

Endoscopic diagnosis and management of gallbladder carcinoma in minimally invasive era: New needs, new models

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