Recent Updates on the Diagnosis and Management of Gallbladder Polyps

Lee, Eaum Seok

Abstract

A polypoid lesions of the gallbladder (PLGs) is defined as any elevated lesion of the mucosal surface of the gallbladder wall. Even though most of the gallbladder polyps are benign in nature, malignant polyps are found in some cases. Because advanced gallbladder cancer displays poor prognosis, early detection and appropriate early measures are important for curative treatment and improvement in long-term survival. Patients who have GB polyps are usually almost always asymptomatic and often diagnosed incidentally by abdomen CT scan or transabdominal ultrasonography (TAUS) imaging. However TAUS and CT scan can not differentiate precancerous and cancerous lesions from cholesterol polyps. To increase the diagnostic accuracy, New imanging modality is being performed. Of the available tests, the accuracy of EUS (or CEH-EUS) for the differentiation of neoplastic from nonneoplastic polyps was higher than that of transabdominal US or CT scan. The cholecystectomy should be undertaken only in cases where there are clinical signs of gallbladder polyps, polyps with diameters greater than 10 mm, fast-growing polyps, sessile polyps or wide-based polyps, patient aged over 50, concurrent gallstones, polyps of the gallbladder in fundibulum or abnormal gallbladder wall US. Gallbladder polyps that are not resected should be followed-up with serial ultrasound examinations. guidelines on the screening interval are not yet available, but follow-up with the same modality is generally recommended after 3-6 months. If there are no changes in size, contour, or vascualrity, the follow-up should be individualized; most often a follow up after another 12-24 months could be recommended up to 5 years at least.