Loading
A small growth on the inside wall of the gallbladder, usually spotted by chance on an ultrasound scan. Most are harmless cholesterol deposits; the risk of cancer rises with size, so polyps of 10 mm or more are removed with the gallbladder and smaller ones are watched or left alone according to set rules.
Answer a few questions from a report and read the guideline statement that applies, quoted word for word with its source. Educational aids to prepare for an appointment, not advice.
Ultrasound-detected gallbladder polyps are common and mostly cholesterol polyps or adenomyomatosis rather than true neoplasms. A systematic review of 5,482 polyps found 0.57 percent malignant and true (neoplastic) polyps in 0.60 percent, with size the main predictor (Elmasry 2016); Cancer Research UK summarises that about 8 percent of polyps of 10 mm or more are malignant and about 4 percent of polyps are that size. The 2022 joint guideline of ESGAR, EAES, EFISDS and ESGE sets the rules: ultrasound as the primary test; cholecystectomy for polyps of 10 mm or more, for symptomatic polyps with no other cause, and for 6 to 9 mm polyps with a risk factor (age over 60, primary sclerosing cholangitis, Asian ethnicity, or a sessile polyp including focal wall thickening over 4 mm); ultrasound follow-up at 6 months, 1 and 2 years for 6 to 9 mm polyps without risk factors and for polyps of 5 mm or less with a risk factor, stopping at 2 years if there is no growth; no follow-up for polyps of 5 mm or less without risk factors; surgery if a polyp reaches 10 mm, discussion if it grows 2 mm or more; and an end to monitoring if it disappears (Foley 2022). In primary sclerosing cholangitis polyps were found in 16 percent of 453 patients and most were benign, with cancer associated with size over 10 mm, growth or a mass-like appearance (van Erp 2020). The mass-forming preinvasive neoplasm of 1 cm or more is the intracholecystic papillary neoplasm (Adsay 2012).
Showing the technology this term belongs to: Ultrasound.
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.
The largest natural history study of gallbladder polyps undermines the surveillance half of the 2022 European guideline: small polyps grow as a matter of course and almost never become cancer, while size at first scan carries most of the risk.
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.
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.
Shares Papillary carcinoma of the gallbladder, Carcinoma in situ and dysplasia of the gallbladder, Gallbladder cancer and the tags gallbladder, biliary.
Shares Carcinoma in situ and dysplasia of the gallbladder, Gallbladder cancer and the tags gallbladder, biliary.
Shares Carcinoma in situ and dysplasia of the gallbladder, Gallbladder cancer and the tags gallbladder, biliary.
Shares Papillary carcinoma of the gallbladder, Carcinoma in situ and dysplasia of the gallbladder, Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials, Gallbladder cancer and the tags gallbladder, biliary.
Shares Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials, Gallbladder cancer and the tags gallbladder, biliary.
Shares Gallbladder cancer and the tags gallbladder, biliary.
Shares Gallbladder cancer and the tags gallbladder, biliary.
Shares Gallbladder cancer and the tags gallbladder, biliary.