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KMID : 0614620230810050197
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Korean Journal of Gastroenterology
2023 Volume.81 No. 5 p.197 ~ p.202
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Recent Updates on Management and Follow-up of Gallbladder Polyps
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Son Jun-Hyuk
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Abstract
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Gallbladder polyps are a common incidental finding. Although most of these are benign, differentiating non-neoplastic from neoplastic polyps is challenging. Trans-abdominal ultrasound is the primary imaging study for diagnosing and monitoring gallbladder polyps. In challenging cases, the use of endoscopic ultrasound or contrast-enhanced endoscopic ultrasound could assist in making decisions. According to current guidelines, a cholecystectomy is recommended in patients with polyps measuring 10 mm or larger and in symptomatic patients with polyps measuring less than 10 mm. A cholecystectomy is also recommended if one or more risk factors for malignancy are present in patients with polyps measuring 6-9 mm. These risk factors include age older than 60 years, primary sclerosing cholangitis, Asian ethnicity, and sessile polyps, including focal gallbladder wall thickening >4 mm. Follow-up ultrasound is recommended at six months, one year, and two years for polyps measuring 6-9 mm in patients without risk factors for malignancy, and for polyps less than 5 mm in patients with one or more risk factors for malignancy. Discontinuing the surveillance could be considered in the absence of growth. Follow-up is not required for polyps measuring less than 5 mm in patients without the risk factors for a malignancy. On the other hand, the evidence for the guidelines is still lacking and of low quality. The management of gallbladder polyps should be individualized based on the currently available guidelines.
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KEYWORD
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Gallbladder, Polyps, Neoplasms, Cholecystectomy
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