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):  

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. 

2020 ◽  
Author(s):  
Dietmar Öfner

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.


2020 ◽  
Vol 2 (2) ◽  
pp. 63-69
Author(s):  
Iea Alabbasi ◽  
Issam Merdan ◽  
Falih Al-Gazgooz

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


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

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

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

Endoscopy ◽  
2006 ◽  
Vol 39 (S 1) ◽  
Author(s):  
M Hattori ◽  
K Inui ◽  
J Yoshino ◽  
K Okushima ◽  
H Miyoshi ◽  
...  

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
John Young ◽  
Anas Belhasan ◽  
Nisheeth Kansal ◽  
Sanjay Taribagil

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.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Linda Heitz ◽  
◽  
Wolfgang Kratzer ◽  
Tilmann Gräter ◽  
Julian Schmidberger

Sign in / Sign up

Export Citation Format

Share Document