The risk of malignancy in ultrasound detected gallbladder polyps: A systematic review
A Liverpool review of twelve studies found that about one in 175 gallbladder polyps seen on ultrasound turned out to be cancer, and argued for risk-based surveillance decided in a multidisciplinary team.
Overview
Systematic review from Aintree University Hospital of 12 studies on the natural history of ultrasound-diagnosed gallbladder polyps. Of 5,482 polyps, malignant polyps had an incidence of 0.57 percent and true (neoplastic) polyps 0.60 percent; 64 patients with adenomatous or malignant polyps were reported. Risk features identified included size over 6 mm, single polyps, symptoms, age over 60, Indian ethnicity, gallstones and cholecystitis. The authors recommend risk assessment, clear surveillance planning and multidisciplinary discussion, with endoscopic ultrasound reserved for its greater sensitivity and specificity.
- Malignant polyps 0.57 percent and true polyps 0.60 percent of 5,482 ultrasound-detected gallbladder polyps.
- Risk features: size over 6 mm, single polyp, symptoms, age over 60, Indian ethnicity, gallstones, cholecystitis.
UK evidence that the polyps found every day on NHS ultrasound lists are almost always benign; it feeds the risk factors used in the 2022 European guideline.
- Heterogeneous retrospective studies with differing follow-up.
- Ultrasound size measurement is operator-dependent.
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