scholarly journals The sonographer dilemma: Ultrasound follow-up in patients with small gallbladder polyps

2021 ◽  
Vol 7 (1) ◽  
pp. 79-82
Author(s):  
Malene Roland Vils Pedersen
Keyword(s):  
Gallbladder Polyps

What should sonographers recommend to patients diagnosed with small gallbladder polyps? Is follow-up always the solution? And for how many years should we encourage patients to participate in a follow-up ultrasound program? This tutorial discusses current research and guidelines. 

scholarly journals Management of gallbladder polyps

2020 ◽  
Author(s):  
Dietmar Öfner
Keyword(s):  
Cancer Detection ◽  
Rare Event ◽  
Imaging Method ◽  
Additional Risk ◽  
Gallbladder Polyps ◽  
Gallbladder Mucosa ◽  
Current Guidelines ◽  
Relevant Level ◽  
Gallbladder Malignancy

Summary A gallbladder polyp (GP) is defined as an elevation of the gallbladder mucosa that protrudes into the gallbladder lumen. Gallbladder polyps (GPs) have an estimated prevalence in adults of 0.3–12.3%. However, only 5% of polyps are considered “true” GPs that have malignant potential or are even already cancerous. The most important imaging method for diagnosis and follow-up of GPs is transabdominal ultrasound, but it fails to discriminate between true and pseudo polyps at a clinically relevant level. Although gallbladder cancer (GBC) arising from polyps is a rare event, malignancy is significantly more common among polyps from a size of 10 mm. In light of this, the consensus, which is reflected in current guidelines, is that surgery should be considered for polyps of 10 mm or greater. However, 10 mm is an arbitrary cutoff, and high-quality evidence to support this is lacking. Lowering the threshold for cholecystectomy when patients have additional risk factors for gallbladder malignancy may improve the cancer detection rate in polyps smaller than 10 mm. Nevertheless, the evidence behind this is also weak. This review shows the shortcomings in the available evidence and underlines the decision-making process regarding the surgical indication, surveillance, or both.

Incidence of cholelithiasis after laparoscopic sleeve gastrectomy

2020 ◽  
Vol 2 (2) ◽  
pp. 63-69
Author(s):  
Iea Alabbasi ◽  
Issam Merdan ◽  
Falih Al-Gazgooz
Keyword(s):  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Weight Reduction ◽  
Gallstone Formation ◽  
Abdominal Ultrasound ◽  
Gallbladder Polyps ◽  
Concomitant Cholecystectomy ◽  
History Of ◽  
Age Range

Background: Laparoscopic sleeve gastrectomy is a well-known method for weight reduction. Post-operative weight loss is a major risk factor for gallstone formation. Objective: To determine whether prophylactic concomitant laparoscopic cholecystectomy should be performed on all patients at the time of laparoscopic sleeve gastrostomy or not. Patients and Methods: A retrospective and prospective study on 540 patients with morbid obesity who underwent laparoscopic sleeve gastrectomy; their BMI range was between 38 and 53, their age range was 18 to 63 years, and 335 of them were females. The exclusion criteria were patients with a history of cholecystectomy, gallstone patients or gallbladder polyps more than 1 cm in preoperative abdominal ultrasound, and those who failed to follow-up. All patients were followed up with every 6–12 months, including those who had cholecystectomy by other surgeons. Results: During the study period, from the total 540 patients who had laparoscopic sleeve gastrectomy, 167 patients (30.92%) had cholecystectomy, out of which 20 patients (3.7%) had achieved 45% weight reduction during the first six months; while in another 6 months, 147 patients (27.22%) had cholecystectomy, achieving additional 30% weight reduction. Conclusions: The incidence of gallstones after laparoscopic sleeve gastrostomy is about 30.92%, indicating that 69.08% will not have gallstones in the postoperative follow-up period, so it would be unwise to do prophylactic concomitant cholecystectomy for all patients. Keywords: Bariatric procedures, cholecystectomy, incidence

Incidentally Detected Gallbladder Polyps: Is Follow-up Necessary?—Long-term Clinical and US Analysis of 346 Patients

Radiology ◽  
2011 ◽  
Vol 258 (1) ◽  
pp. 277-282 ◽  
Author(s):  
Michael T. Corwin ◽  
Bettina Siewert ◽  
Robert G. Sheiman ◽  
Robert A. Kane
Keyword(s):  
Gallbladder Polyps

scholarly journals Management and follow up of gallbladder polyps: The Norfolk and Norwich experience

2018 ◽  
Vol 55 ◽  
pp. S61
Author(s):  
A. Ismail ◽  
M. Aker ◽  
B. Kumar ◽  
S. Wemyss-Holden
Keyword(s):  
Gallbladder Polyps

scholarly journals Recent Updates on Diagnosis, Treatment, and Follow-up of Gallbladder Polyps

2020 ◽  
Vol 76 (3) ◽  
pp. 102-107
Author(s):  
Sung Ill Jang ◽  
Jae Hee Cho ◽  
Dong Ki Lee
Keyword(s):  
Gallbladder Polyps

Follow-up study of gallbladder polyps diagnosed as benign with endoscopic ultrasonography

Endoscopy ◽  
2006 ◽  
Vol 39 (S 1) ◽  
Author(s):  
M Hattori ◽  
K Inui ◽  
J Yoshino ◽  
K Okushima ◽  
H Miyoshi ◽  
...  
Keyword(s):  
Endoscopic Ultrasonography ◽  
Gallbladder Polyps ◽  
Follow Up Study

scholarly journals P-BN22 The use of virtual clinics in gallbladder polyp surveillance

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
John Young ◽  
Anas Belhasan ◽  
Nisheeth Kansal ◽  
Sanjay Taribagil
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Risk Groups ◽  
Gallbladder Polyp ◽  
Gallbladder Polyps ◽  
Lost To Follow Up ◽  
Current Guidelines ◽  
Gallbladder Malignancy ◽  
Virtual Clinic

Abstract Background Gallbladder polyps are common findings on ultrasound with a prevalence between 0.3-9.5%. Their significance is not clear but are theorised to have potential risk of transformation into gallbladder malignancy which have poor prognosis if not caught early. Current guidelines recommend surveillance of polyps and that laparoscopic cholecystectomy should be offered if certain criteria are met. Most patients are asymptomatic and regular reviews in clinic is time consuming for patients and adds to strain on services. This study looks at the use of virtual clinics in gallbladder polyp surveillance. Methods Since January 2019 patients identified with gallbladder polyps have been added to virtual clinic. Each patient is added to a database which is maintained by one upper GI surgeon. Current guidelines are followed: laparoscopic cholecystectomy is offered if polyps are greater than 1cm, there is an increase greater than 2mm between scans, and in high-risk groups or in symptomatic patients. All other patients are offered interval scans as per guidelines and a template letter is generated informing patients of their scan results and date of their follow up scan. Results Since January 2019, 70 patients have been identified to have gallbladder polyps. Of these 48 patients so far have benefitted from involvement from follow up in virtual clinic to date, this has resulted in 88 clinic appointments being saved. 12 patients have undergone laparoscopic cholecystectomy due to increase in size of their gallbladder polyps or secondary to symptoms. 7 patients have been lost to follow up, 2 discharged due to the gallbladder polyps disappearing and the other 49 remain under surveillance in the virtual clinic. Conclusions Long term polyp surveillance can be time consuming for both the patient and clinician. This model of a virtual clinic maintains clear communication with patients about their scan findings, the risks associated and plans for future scans. This is an efficient method of monitoring these patients that has good compliance and identifies patients appropriate for surgery.

scholarly journals P-O03 The Management of Gallbladder Polyps at a Single Trust: Are we compliant with European Guidelines?

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Elias Jamieson ◽  
Chloe Short ◽  
Rachael Clifford ◽  
Kunal Rajput
Keyword(s):  
Risk Groups ◽  
Outpatient Setting ◽  
Definitive Treatment ◽  
Diagnostic Challenge ◽  
Polyp Size ◽  
Adherence To Guidelines ◽  
Gallbladder Polyps ◽  
Abdominal Radiology ◽  
European Guidelines

Abstract Background Gallbladder polyps affect approximately 5% of the global population, with rates highest in those of Indian descent. 10% of polyps will have malignant potential based on their size or rapid growth rate, which are associated with a poor 5-year survival once advanced of less than 25%. As gallbladder polyps are common but gallbladder cancer is rare, it is a diagnostic challenge to determine which polyps are likely to be malignant. Adherence to guidelines regarding radiological follow up and definitive treatment, in the form of a cholecystectomy, is therefore vital. Methods Retrospective data collection and analysis was completed for all patients who had a biliary ultrasound between December 2013 and December 2016 to enable 5-year follow up, and a snapshot of 47 patients selected at random. Patients having a gallbladder “polyp” documented on their scan report were eligible for inclusion and adherence to European Society of Gastrointestinal and Abdominal Radiology (ESGAR) guidelines was assessed. Results Within the cohort there was a mean age of 56 years, with a male:female ratio of 17:30. All patients included were Caucasian, with 41 reporting “biliary symptoms” as the indication for the primary ultrasound. 26 patients were not followed up in adherence to guidelines, with 50% due to the sonographer reporting follow-up was not indicated on initial scan, 5 having unchanged polyp size and 2 discharged by the responsible consultant. Of the 21 who were followed up according to guidelines, 20 had a cholecystectomy within 5years, with none of these patients having cancer detected on histology. Conclusions Over 50% of patients within our cohort were not followed up according to the ESGAR guidelines. Although no patients in the study were found to have malignant polyps, the sample size is relatively small and limited to low-risk groups. We aim to expand this audit both locally and regionally, raise awareness of the importance of surveillance across the multi-disciplinary team, and produce local guidance for the outpatient setting.

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