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In the Dutch national pathology archive fewer than one in a hundred removed gallbladders contained a polyp, more than four in ten of those polyps were harmless, and the one-centimetre rule for operating sorted them only moderately well.
PALGA nationwide pathology registry study of all histologically proven gallbladder polyps and focal wall thickenings over 5 mm between 2003 and 2013: 2,085 of 220,612 cholecystectomies (0.9 percent). Of these, 56.4 percent were neoplastic (40.1 percent premalignant, 59.9 percent malignant) and 43.6 percent non-neoplastic (41.5 percent cholesterol polyps, 37.0 percent adenomyomatosis). Neoplastic polyps were larger (18.1 versus 7.5 mm). Clinicopathological features differed but could not reliably indicate neoplasia, and the 1 cm surgical threshold had moderate diagnostic accuracy.
Size is a blunt tool: a 10 mm cut-off sends many people with cholesterol polyps to surgery and misses some neoplastic polyps below it. Better imaging (contrast-enhanced or endoscopic ultrasound) or a risk score is the research need the 2022 guideline itself acknowledges.
Shares Gallbladder polyp (polypoid lesion), Overdiagnosis, Ultrasound, Gallbladder cancer and the tag gallbladder-evidence.
Shares Gallbladder polyp (polypoid lesion), Ultrasound, Gallbladder cancer and the tag gallbladder-evidence.
Shares Gallbladder polyp (polypoid lesion), Overdiagnosis, Ultrasound, Gallbladder cancer and the tag gallbladder-evidence.
Shares Gallbladder polyp (polypoid lesion), Overdiagnosis, Ultrasound, Gallbladder cancer and the tag gallbladder-evidence.
Shares Gallbladder cancer and the tag gallbladder-evidence.
Shares Gallbladder cancer and the tag gallbladder-evidence.
Shares Gallbladder cancer and the tag gallbladder-evidence.
Shares Gallbladder cancer and the tag gallbladder-evidence.