Management and follow-up of gallbladder polyps : Joint guidelines between the European Society of Gastrointestinal and Abdominal Radiology (ESGAR), European Association for Endoscopic Surgery and other Interventional Techniques (EAES), International Society of Digestive Surgery - European Federation (EFISDS) and European Society of Gastrointestinal Endoscopy (ESGE)

Eur Radiol. 2017 Sep;27(9):3856-3866. doi: 10.1007/s00330-017-4742-y. Epub 2017 Feb 9.

Abstract

Objectives: The management of incidentally detected gallbladder polyps on radiological examinations is contentious. The incidental radiological finding of a gallbladder polyp can therefore be problematic for the radiologist and the clinician who referred the patient for the radiological examination. To address this a joint guideline was created by the European Society of Gastrointestinal and Abdominal Radiology (ESGAR), European Association for Endoscopic Surgery and other Interventional Techniques (EAES), International Society of Digestive Surgery - European Federation (EFISDS) and European Society of Gastrointestinal Endoscopy (ESGE).

Methods: A targeted literature search was performed and consensus guidelines were created using a series of Delphi questionnaires and a seven-point Likert scale.

Results: A total of three Delphi rounds were performed. Consensus regarding which patients should have cholecystectomy, which patients should have ultrasound follow-up and the nature and duration of that follow-up was established. The full recommendations as well as a summary algorithm are provided.

Conclusions: These expert consensus recommendations can be used as guidance when a gallbladder polyp is encountered in clinical practice.

Key points: • Management of gallbladder polyps is contentious • Cholecystectomy is recommended for gallbladder polyps >10 mm • Management of polyps <10 mm depends on patient and polyp characteristics • Further research is required to determine optimal management of gallbladder polyps.

Keywords: Cholecystectomy; Gallbladder; Neoplasms; Polyps; Ultrasonography.

Publication types

  • Practice Guideline

MeSH terms

  • Aged
  • Cholangitis, Sclerosing / diagnosis
  • Cholangitis, Sclerosing / surgery
  • Cholecystectomy / methods
  • Consensus
  • Endoscopy, Gastrointestinal / methods*
  • Female
  • Follow-Up Studies
  • Gallbladder Neoplasms / diagnosis
  • Gallbladder Neoplasms / ethnology
  • Gallbladder Neoplasms / surgery*
  • Gastrointestinal Neoplasms / surgery
  • Humans
  • Incidental Findings
  • Male
  • Middle Aged
  • Polyps / diagnosis
  • Polyps / ethnology
  • Polyps / surgery*
  • Radiography, Abdominal
  • Risk Factors
  • Ultrasonography