Current practices and future prospects for the management of gallbladder polyps: A topical review

World J Gastroenterol. 2018 Jul 14;24(26):2844-2852. doi: 10.3748/wjg.v24.i26.2844.

Abstract

A gallbladder polyp is an elevation of the gallbladder mucosa that protrudes into the gallbladder lumen. Gallbladder polyps have an estimated prevalence in adults of between 0.3%-12.3%. However, only 5% of polyps are considered to be "true" gallbladder polyps, meaning that they are malignant or have malignant potential. The main radiological modality used for diagnosing and surveilling gallbladder polyps is transabdominal ultrasonography. However, evidence shows that other modalities such as endoscopic ultrasound may improve diagnostic accuracy. These are discussed in turn during the course of this review. Current guidelines recommend cholecystectomy for gallbladder polyps sized 10 mm and greater, although this threshold is lowered when other risk factors are identified. The evidence behind this practice is relatively low quality. This review identifies current gaps in the available evidence and highlights the necessity for further research to enable better decision making regarding which patients should undergo cholecystectomy, and/or radiological follow-up.

Keywords: Gallbladder cancer; Gallbladder polyps; Pseudo polyps; True polyps.

Publication types

  • Review

MeSH terms

  • Cholecystectomy / standards*
  • Cholecystectomy / trends
  • Clinical Decision-Making
  • Gallbladder / diagnostic imaging
  • Gallbladder / pathology
  • Gallbladder / surgery
  • Gallbladder Diseases / diagnostic imaging
  • Gallbladder Diseases / epidemiology
  • Gallbladder Diseases / pathology
  • Gallbladder Diseases / surgery*
  • Gallbladder Neoplasms / prevention & control*
  • Humans
  • Magnetic Resonance Imaging
  • Patient Selection*
  • Polyps / diagnostic imaging
  • Polyps / epidemiology
  • Polyps / pathology
  • Polyps / surgery*
  • Practice Guidelines as Topic
  • Prevalence
  • Risk Factors
  • Tomography, X-Ray Computed
  • Ultrasonography / methods