Incidentally detected gallbladder polyps

Is follow-up necessary?-long-term clinical and US analysis of 346 patients

Michael T Corwin, Bettina Siewert, Robert G. Sheiman, Robert A. Kane

Research output: Contribution to journalArticle

51 Citations (Scopus)

Abstract

Purpose: To determine the natural history of gallbladder (GB) polyps incidentally detected at ultrasonography (US) and to propose management guidelines for these lesions based on polyp size. Materials and Methods: The HIPAA-compliant study was approved by the institutional review board, and informed consent was waived. A database search for "polyp" in all US examinations of the GB between January 1, 1999, and December 31, 2001, at a single institution was performed. All subsequent US reports were reviewed to determine changes in GB polyp size. The electronic medical record was searched to obtain clinical and pathologic follow-up. Results: Three hundred forty-six patients (mean age, 51.6 years; range, 20-93 years) with GB polyps were included. There were 156 men (45%) and 190 women (55%). US follow-up (mean, 5.4 years; range, 2-11.5 years) was performed in 149 patients (43%). Polyp size was stable in 90 (60%) polyps, decreased in eight (5%), increased in one (1%), and resolved in 50 (34%). Forty-two patients (12%) underwent cholecystectomy, revealing 13 (31%) GBs with polypoid lesions, 24 (57%) with stones and no polyps, and five (12%) with neither a stone nor a polypoid lesion. Clinical follow-up (mean, 8 years; range, 5-10.4 years) was performed in 155 patients (45%). No patient had clinical evidence of GB-related disease. Overall, no cases of GB malignancy were identified in 346 patients. Mean polyp size was 5.0 mm (range, 1-18 mm). No neoplastic polyps were found at 1-6 mm, one neoplastic polyp was seen at 7-9 mm, and two neoplastic polyps were found at 10 mm or larger. Conclusion: The risk of GB malignancy resulting from incidentally detected polyps is extremely low. Incidentally detected GB polyps measuring 6 mm or less may require no additional follow-up. Data are inconclusive regarding polyps 7 mm or greater, and further studies are warranted.

Original languageEnglish (US)
Pages (from-to)277-282
Number of pages6
JournalRadiology
Volume258
Issue number1
DOIs
StatePublished - Jan 2011
Externally publishedYes

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Polyps
Gallbladder
Ultrasonography
Health Insurance Portability and Accountability Act
Gallbladder Diseases
Electronic Health Records
Research Ethics Committees
Cholecystectomy
Natural History
Informed Consent
Neoplasms

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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Incidentally detected gallbladder polyps : Is follow-up necessary?-long-term clinical and US analysis of 346 patients. / Corwin, Michael T; Siewert, Bettina; Sheiman, Robert G.; Kane, Robert A.

In: Radiology, Vol. 258, No. 1, 01.2011, p. 277-282.

Research output: Contribution to journalArticle

Corwin, Michael T ; Siewert, Bettina ; Sheiman, Robert G. ; Kane, Robert A. / Incidentally detected gallbladder polyps : Is follow-up necessary?-long-term clinical and US analysis of 346 patients. In: Radiology. 2011 ; Vol. 258, No. 1. pp. 277-282.
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abstract = "Purpose: To determine the natural history of gallbladder (GB) polyps incidentally detected at ultrasonography (US) and to propose management guidelines for these lesions based on polyp size. Materials and Methods: The HIPAA-compliant study was approved by the institutional review board, and informed consent was waived. A database search for {"}polyp{"} in all US examinations of the GB between January 1, 1999, and December 31, 2001, at a single institution was performed. All subsequent US reports were reviewed to determine changes in GB polyp size. The electronic medical record was searched to obtain clinical and pathologic follow-up. Results: Three hundred forty-six patients (mean age, 51.6 years; range, 20-93 years) with GB polyps were included. There were 156 men (45{\%}) and 190 women (55{\%}). US follow-up (mean, 5.4 years; range, 2-11.5 years) was performed in 149 patients (43{\%}). Polyp size was stable in 90 (60{\%}) polyps, decreased in eight (5{\%}), increased in one (1{\%}), and resolved in 50 (34{\%}). Forty-two patients (12{\%}) underwent cholecystectomy, revealing 13 (31{\%}) GBs with polypoid lesions, 24 (57{\%}) with stones and no polyps, and five (12{\%}) with neither a stone nor a polypoid lesion. Clinical follow-up (mean, 8 years; range, 5-10.4 years) was performed in 155 patients (45{\%}). No patient had clinical evidence of GB-related disease. Overall, no cases of GB malignancy were identified in 346 patients. Mean polyp size was 5.0 mm (range, 1-18 mm). No neoplastic polyps were found at 1-6 mm, one neoplastic polyp was seen at 7-9 mm, and two neoplastic polyps were found at 10 mm or larger. Conclusion: The risk of GB malignancy resulting from incidentally detected polyps is extremely low. Incidentally detected GB polyps measuring 6 mm or less may require no additional follow-up. Data are inconclusive regarding polyps 7 mm or greater, and further studies are warranted.",
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