Ultrasonography Incorrectly Diagnoses Gallbladder Polyps

Diagnostic accuracy of transabdominal ultrasonography for gallbladder polyps: systematic review

“…2 Generally, pseudopolyps are more likely to be found on final pathologic examination than gallstones, which indicates that the former are more difficult to distinguish from true polyps and are more likely to confound ultrasonography diagnosis. A li C h a n n a e t a l. 1 2 C h a t t o p a d h y a y e t a l. 1 3 C h o i e t a l. 5 D a m o r e e t a l. 4 F r e n c h e t a l. 3 H u a n g e t a l. 1 4 I t o e t a l. 8 K h a n e t a l. 1 5 M a in p r iz e e t a l. 1 6 P a r k e t a l. 1 7 S a r k u t e t a l. 1 8 X u e t a l. 1 9 Z ie li n s k i e t a l. Other imaging modalities have also been shown to be inaccurate in measuring polyps, and the modalities are not well correlated with one another. Choi and colleagues 5 showed that there was a mean difference of 5.66 mm in measurements of polyps for cholesterolosis between ultrasonography and computed tomography and a mean difference of 2.17 mm in measurements of noncholesterol polyps.…”

“…A li C h a n n a e t a l. 1 2 C h a t t o p a d h y a y e t a l. 1 3 C h o i e t a l. 5 D a m o r e e t a l. 4 F r e n c h e t a l. 3 H u a n g e t a l. 1 4 I t o e t a l. 8 K h a n e t a l. 1 5 M a in p r iz e e t a l. 1 6 P a r k e t a l. 1 7 S a r k u t e t a l. 1 8 X u e t a l. 1 9 Z ie li n s k i e t a l. polypoid lesion that is smaller or is not present on computed tomography, as compared to a lesion seen on ultrasonography, is more likely to be cholesterolosis than a true polyp, which was supported by Song and colleagues. 21 Song and colleagues 21 also found that polyps diagnosed on ultrasonography were more likely to be cholesterolosis in young patients with a high body mass index.…”

“…Polyps measuring 10 mm or less should be managed with watchful waiting (with uncertainty regarding the number or frequency of visits or ultrasonography examinations required), those measuring 11-20 mm should be managed with close follow-up or cholecystectomy, and those larger than 20 mm require cholecystectomy. 2,4 Transabdominal ultrasonography has been shown to be inaccurate in measuring the size of polypoid gallbladder lesions. Choi and colleagues 5 found a mean deviation of only 0.89 mm for true polyps, but Guo and colleagues 6 reported that transabdominal ultrasonography universally overestimates polyp size by 4.24 mm (standard deviation [SD] 0.19 mm).…”

“…Previous studies have shown poor correlation between ultrasonography diagnosis and final pathology, [2][3][4] and an attempted meta-analysis was aborted owing to a lack of satisfactory research. 2 This diagnostic uncertainty introduces the potential for unnecessary imaging, unnecessary surgery and all the associated risks to patients and costs to the health care system.…”

Laparoscopic Management of Gall Bladder Polyp

“…Many of the small polyps seen on sonography most likely represented a stone embedded in the gallbladder wall or other abnormality. [17] Three-dimensional ultrasonography Three-dimensional ultrasound (3DUS) diagnosis correlates well with two-dimensional ultrasound (2DUS) with regard to most gallbladder problems and could be sufficient as a stand-alone technique. [18] …”