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The 2022 European rules for gallbladder polyps found on ultrasound: operate at 10 mm or more, operate at 6 to 9 mm if there are risk factors, scan again for two years otherwise, and stop watching tiny polyps in people without risk factors.
Update of the 2017 joint recommendations of the European Society of Gastrointestinal and Abdominal Radiology, the European Association for Endoscopic Surgery, the European Federation of the International Society of Digestive Surgery and the European Society of Gastrointestinal Endoscopy. Ultrasound is the primary investigation. Cholecystectomy is recommended for polypoid lesions of 10 mm or more (strong recommendation, low-quality evidence), for symptomatic polyps, and for 6 to 9 mm polyps with a risk factor: age over 60, primary sclerosing cholangitis, Asian ethnicity, or a sessile lesion including focal wall thickening over 4 mm.
Polyps of 6 to 9 mm without risk factors, or 5 mm or less with risk factors, get ultrasound at 6 months, 1 and 2 years and are discharged if they have not grown; 5 mm or less without risk factors need no follow-up. Growth to 10 mm means surgery; growth of 2 mm or more within two years prompts multidisciplinary discussion; a polyp that disappears ends monitoring.
This is the polyp pathway UK radiologists and surgeons follow (a UK author, Foley, leads it). It is a surveillance-and-surgery guideline built on low to moderate quality evidence, and the Kaiser Permanente cohort published two years earlier questions whether following small polyps finds cancer at all.
Shares Gallbladder polyp (polypoid lesion), Overdiagnosis, Ultrasound, Screening and the tag gallbladder-evidence.
Shares Gallbladder polyp (polypoid lesion), Overdiagnosis, Ultrasound, Gallbladder cancer and the tag gallbladder-evidence.
Shares Gallbladder polyp (polypoid lesion), Ultrasound, Screening, Gallbladder cancer and the tag gallbladder-evidence.
Shares Gallbladder polyp (polypoid lesion), Overdiagnosis, Ultrasound, Screening and the tag gallbladder-evidence.
Shares Screening, Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials, Gallbladder cancer and the tag gallbladder-evidence.
Shares Screening, Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials, Gallbladder cancer and the tag gallbladder-evidence.
Shares Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials, Gallbladder cancer and the tag gallbladder-evidence.
Shares Screening, Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials, Gallbladder cancer and the tag gallbladder-evidence.