Incidentally Detected Gallbladder Polyps: Is Follow-up Necessary?—Long-term Clinical and US Analysis of 346 Patients

Corwin, Michael T.; Siewert, Bettina; Sheiman, Robert G.; Kane, Robert A.

doi:10.1148/radiol.10100273

Cited by 97 publications

(58 citation statements)

References 20 publications

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“…Sonography has been used extensively in the pre-operative management of polyps, but this technique is generally not sufficient to differentiate between benign and malignant polyps, with the exception of advanced gallbladder cancer [18,19]. On the other hand, the overall prognosis for gallbladder cancer is extremely poor, with less than a 10% 5-year survival rate [6,20]. Current guidelines in the management of gallbladder polyps are generally established on the basis of polyp size, which recommend sonography follow-up for polyps smaller than 10 mm and surgical intervention for those 10 mm or greater [5].…”

Section: Discussionmentioning

confidence: 99%

“…Current guidelines in the management of gallbladder polyps are generally established on the basis of polyp size, which recommend sonography follow-up for polyps smaller than 10 mm and surgical intervention for those 10 mm or greater [5]. However, this strategy may well produce increased patient anxiety and unnecessary follow-up examinations [6]. Therefore, a novel diagnostic approach based on polyp imaging findings other than the size criteria can help in polyp characterization.…”

Section: Discussionmentioning

confidence: 99%

“…The majority of gallbladder polyps are benign and most commonly include cholesterol polyps or inflammatory polyps [5,6]. In rare cases, these lesions may be neoplastic, and sometimes share the same appearance as benign polyps on sonographic examination [7].…”

Section: Introductionmentioning

confidence: 99%

“…In rare cases, these lesions may be neoplastic, and sometimes share the same appearance as benign polyps on sonographic examination [7]. Current guidelines suggest surgical removal of polyps greater than 10 mm and follow-up with subsequent sonography for polyps smaller than 10 mm [5,6]. However, the accuracy of the size criteria is limited because the gallbladder neoplastic polyps are sometimes found less than 10 mm [8].…”

Section: Introductionmentioning

confidence: 99%

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The use of real-time elastography in the assessment of gallbladder polyps: preliminary observations

Teber¹,

Tan²,

Dönmez³

et al. 2014

Med Ultrason

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Aims: Gallbladder polyps often have a benign nature. Current guidelines suggest surgical removal of polyps greater than 10 mm. However, the accuracy of the size criteria is limited because neoplasia can be found in gallbladder polyps less than 10 mm. The aim of this study was to evaluate the feasibility of real time elastography for gallbladder polyps and to demonstrate the elasticity properties of the polyps. Material and method: Fifty-three polypoid lesions of the gallbladder were prospectively examined with real-time elastography. Of these patients, 52 had a diagnosis of benign gallbladder polyps and one patient was accepted as a gallbladder carcinoma due to its clinical and radiological findings. B-mode and real-time elastographic images were simultaneously presented as a two-panel image, and the elastogram was displayed in a color scale that ranged from red (greatest strain, softest component), to green (average strain, intermediate component), to blue (no strain, hardest component). Results: The mean size for benign gallbladder polyps was 7.2 ± 3 mm (range, 5-21 mm). All benign gallbladder polyps on consecutive real-time elastographic images appeared as having a high-strain elastographic pattern. Only one patient who was accepted with gallbladder carcinoma had a gallbladder polyp with low elasticity properties. Conclusions: Our study showed that real time elastography of gallbladder polyps is feasible. This novel approach may be useful for the characterization of polypoid lesions of the gallbladder.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The use of real-time elastography in the assessment of gallbladder polyps: preliminary observations

Teber¹,

Tan²,

Dönmez³

et al. 2014

Med Ultrason

View full text Add to dashboard Cite

show abstract

“…Of these, cholelithiasis is the most common pathology that affects 10-15% of the adult population. Other conditions such as gallbladder polyp are found in about 5% of the global population, while the estimated incidence of gallbladder cancer is approximately two cases per 100,000 population worldwide [1,2].…”

Section: Introductionmentioning

confidence: 99%

Endoscopic Ultrasonography (EUS) and Gallbladder

Alizadeh¹

2017

Updates in Gallbladder Diseases

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Diseases of the gallbladder commonly manifest as cholelithiasis and gallbladder cancer. Cholelithiasis has become a significant health problem in developed societies, affecting 10-15% of the adult population. Gallbladder polyps are incidentally detected in approximately 4-7% of patients. In addition, other gallbladder problems may also occur, but these are extremely rare: remnant cystic duct, gallbladder anomalies, Mirizzi syndrome, and gallbladder parasites. Endoscopic ultrasound (EUS) is an excellent method for visualizing the bile duct and gallbladder given its proximity when imaging from the duodenum. EUS can be used for evaluation of gallbladder disease that includes investigation of suspected cholelithiasis or biliary sludge, imaging of polypoid lesions of the gallbladder, and diagnosis and staging of gallbladder cancer. This procedure can be helpful to further distinguish benign from malignant or potentially malignant gallbladder polyps and play an important role in determining the treatment strategy for gallbladder polyps. Furthermore, EUS can help in the diagnosis of rarely gallbladder diseases such as remnant cystic duct, gallbladder anomalies, Mirizzi syndrome, and gallbladder parasites. Recent studies have suggested that EUS-guided gallbladder drainage (EUS-GBD) can be considered to be an effective emergency treatment for acute cholecystitis patients at high risk for surgery.

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Risk and Cost-effectiveness of Surveillance Followed by Cholecystectomy for Gallbladder Polyps

Cairns¹,

Neal²,

Dennison³

et al. 2012

Arch Surg

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Main Outcome Measures: Demographic data and size and number of polyps were recorded as well as size increase and histological findings. Detection rates for potentially neoplastic and frankly neoplastic polyps were recorded and compared with complication rates from cholecystectomy. Cost-effectiveness of ultrasonography surveillance was examined. Results: Nine hundred eighty-six patients were identified and 467 patients underwent further follow-up. Only 6.6% of polyps exhibited an increase in size over the surveillance period. Polyps that subsequently progressed in size on surveillance had a significantly greater diameter at first presentation than those polyps that remained static (7 mm vs 5 mm, respectively) (PϽ.05). Only 3.7% of resected polyps had malignant or potentially malignant histology. Size greater than 10 mm and increase in size during surveillance predicted neoplastic potential. Conclusions: A surveillance with or without selective surgery policy could potentially detect and prevent 5.4 gallbladder cancers per 1000 individuals per year with a cost saving of more than £130 000 (US $201 676) per year. Cancer prevention benefits would exceed the risk ratios from cholecystectomy complications. Polyps greater than 10 mm should be resected; those between 5 and 10 mm should be under ultrasonography surveillance.

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Incidentally Detected Gallbladder Polyps: Is Follow-up Necessary?—Long-term Clinical and US Analysis of 346 Patients

Abstract: The risk of GB malignancy resulting from incidentally detected polyps is extremely low. Incidentally detected GB polyps measuring 6 mm or less may require no additional follow-up. Data are inconclusive regarding polyps 7 mm or greater, and further studies are warranted.

Cited by 97 publications

References 20 publications

The use of real-time elastography in the assessment of gallbladder polyps: preliminary observations

The use of real-time elastography in the assessment of gallbladder polyps: preliminary observations

Endoscopic Ultrasonography (EUS) and Gallbladder

Risk and Cost-effectiveness of Surveillance Followed by Cholecystectomy for Gallbladder Polyps

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