Korean J Gastroenterol.  2023 May;81(5):197-202. 10.4166/kjg.2023.038.

Recent Updates on Management and Follow-up of Gallbladder Polyps

• Son JH

• KMID: 2542785
• DOI: http://doi.org/10.4166/kjg.2023.038

Abstract

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.

Keyword

Gallbladder; Polyps; Neoplasms; Cholecystectomy

Figure

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  Fig. 1 Management and follow-up of gallbladder polyps according to 2022 European joint guidelines. GB, gallbladder; TAUS, transabdominal ultrasonography.

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