Diagnosis Of Gallbladder Polyps Research Articles

Preliminary study on diagnosis of gallbladder neoplastic polyps based on contrast-enhanced ultrasound and grey scale ultrasound radiomics.

Neoplastic gallbladder polyps (GPs), including adenomas and adenocarcinomas, are considered absolute indications for surgery; however, the distinction of neoplastic from non-neoplastic GPs on imaging is often challenging. This study thereby aimed to develop a CEUS radiomics nomogram, and evaluate the role of a combined grey-scale ultrasound and CEUS model for the prediction and diagnosis of neoplastic GPs. Patients with GPs of ≥ 1cm who underwent CEUS between January 2017 and May 2022 were retrospectively enrolled. Grey-scale ultrasound and arterial phase CEUS images of the largest section of the GPs were used for radiomics feature extraction. Features with good reproducibility in terms of intraclass correlation coefficient were selected. Grey-scale ultrasound and CEUS Rad-score models were first constructed using the Mann-Whitney U and LASSO regression test, and were subsequently included in the multivariable logistic regression analysis as independent factors for construction of the combined model. A total of 229 patients were included in our study. Among them, 118 cholesterol polyps, 68 adenomas, 33 adenocarcinomas, 6 adenomyomatoses, and 4 inflammatory polyps were recorded. A total of 851 features were extracted from each patient. Following screening, 21 and 15 features were retained in the grey-scale and CEUS models, respectively. The combined model demonstrated AUCs of 0.88 (95% CI: 0.83 - 0.93) and 0.84 (95% CI: 0.74 - 0.93) in the training and testing set, respectively. When applied to the whole dataset, the combined model detected 111 of the 128 non-neoplastic GPs, decreasing the resection rate of non-neoplastic GPs to 13.3%. Our proposed combined model based on grey-scale ultrasound and CEUS radiomics features carries the potential as a non-invasive, radiation-free, and reproducible tool for the prediction and identification of neoplastic GPs. Our model may not only guide the treatment selection for GPs, but may also reduce the surgical burden of such patients.

Diagnostic Performance of Endoscopic Ultrasound Elastography for Differential Diagnosis of Gallbladder Polyp

It is difficult to differentiate between neoplastic and non-neoplastic gallbladder (GB) polyps before surgery. Endoscopic ultrasound-elastography (EUS-EG) is a non-invasive complementary diagnostic method. The utility of EUS-EG in the differential diagnosis of GB polyps has not been investigated. We aimed to investigate the diagnostic performance of EUS-EG for the differential diagnosis of GB polyps. Patients with GB polyps were prospectively enrolled from June 2020 until November 2022. EUS-EG and semi-quantitative evaluation of the strain ratio (SR) were performed for differential diagnosis of GB polyps. Fifty-three eligible patients were divided into two groups based on the final diagnosis after surgery. Patient demographics, EUS characteristics, and SR values were compared. Receiver-operating characteristic (ROC) curve analysis was performed to determine the optimal cutoff SR value that discriminates between neoplastic and non-neoplastic GB polyps. The median SR value for neoplastic polyps (32.93 [interquartile range: 22.37-69.02]) was significantly higher than for non-neoplastic polyps (5.40 [2.36-14.44]; p<0.001). There were significant differences in SR values between non-neoplastic, benign neoplastic (23.38 [13.62-39.04]), and malignant polyps (49.25 [27.90-82.00]). The optimal cut-off SR value to differentiate between neoplastic and non-neoplastic polyps was 18.4. In multivariable logistic regression, SR value >18.4 (odds ratio 33.604, 95% confidence interval 2.588-436.292) was an independent predictor of neoplastic polyps. EUS-EG and SR values can be used as a supplementary method for evaluating GB polyps.

OGBN P11 Gallbladder polyps: an audit of management in an NHS trust

Abstract Background Gallbladder polyps are elevations in the gallbladder wall which project into the lumen. These can be either true polyps or “pseudopolyps” (such as cholesterol or inflammatory deposits or focal adenomyomatosis). Polyp prevalence has been estimated as high as 9.5% in some studies, of which 70% may be pseudopolyps. A small minority of true polyps may display malignant potential. Gallbladder malignancy is aggressive, especially when diagnosed at later stages of disease with poor treatment options and survival outcomes. However, Stage I disease has excellent 5 year survival rates, nearing 100%. Early identification of patients at risk of gallbladder malignancy is highly important and may detect curable disease. Joint guidelines between the European Society of Gastrointestinal and Abdominal Radiology (ESGAR), European Association for Endoscopic Surgery (EAES), International Society of Digestive Surgery – European Federation (EFISDS) and European Society of Gastrointestinal Endoscopy (ESGE) have outlined best practice in regards to management of gallbladder polyps. This audit compared the current practice in a NHS healthcare trust against these guidelines in order to develop trust-wide consensus and guidelines for future management. Methods A PACS based radiology search was conducted, identifying all patients who underwent an ultrasound between 10th December 2020 and 10th December 2021, whose imaging report used the term “gallbladder polyp(s)” within a hospital trust. Patients without a diagnosis of gallbladder polyp were excluded from the audit. Historical patient records were accessed via the trust-based online patient database (Clinical Portal). Data were collected and analysed using Microsoft excel. Patient management was compared against the following ESGAR/EAES/EFISDS/ESGE guidelines: Results A total of fifty six patients fit the inclusion criteria, with an age range of 8 to 96 years. The majority were female (63%). Polyp size ranged from &amp;lt;2mm to 14mm. Patients were predominantly managed by Upper GI surgery, gastroenterology and general practice with the Radiology department performing and reporting ultrasounds and advising management or follow up. Results showed that 86% of patients were appropriately offered surgery for polyps ≥ 10mm. However, 40% of patients with polyps &amp;gt;5mm with risk factors, were not offered cholecystectomy and 44% of those without risk factors were not offered appropriate follow up. The majority of patients with polyps ≤ 5mm with risk factors were not offered ultrasound surveillance. All patients without risk factors with polyps ≤ 5mm were appropriately managed. Conclusions Key findings suggest discrepancies in the management of patients with gallbladder polyps in a NHS Trust. In particular, patients with risk factors and polyps between 6–9mm were not always identified as requiring operative management. Likewise, over half of those without risk factors were not offered surveillance imaging. Poor management and lack of follow up may put patients at risk. The results of this audit demonstrate the need for unified local or national guidelines concerning management of gallbladder polyps and consensus across multiple disciplines.

Clinical Study on Ultrasonic Diagnosis in the Diagnosis of Gallbladder Polyps

Clinical Study on Ultrasonic Diagnosis in the Diagnosis of Gallbladder Polyps

A New Risk Scoring System to Predict Malignancy in Gallbladder Polyps: a Single-Center Study

ObjectiveUltrasonography (US) is the most commonly used radiological method in the diagnosis of gallbladder polyps (GBPs). Patients diagnosed with GBPs on US are operated on with risk factors that do not have a high level of evidence. Our aim in this study is to determine the sensitivity of US in diagnosis GBPs, to define risk factors for neoplastic (NP) polyps, and to develop the risk scoring system. Materials and MethodsBetween July 2011 and July 2021, 173 patients who were found to have GBPs in the pathology specimens after cholecystectomy were included in the study. Patients were divided into two groups: nonneoplastic and NP groups. ResultsGBPs in patients who underwent abdominal US for any reason was 4.5%. The sensitivity of US in the diagnosis of GBPs was 56.6%. Comparison between groups, age ≥50, presence of symptoms, polyp size >12.5mm, single polyp, concomitant gallstones, and gallbladder wall thickness ≥4mm were statistically in the NP group. A risk scoring system was developed using these values. If the risk score was <4, 0.6% of GBPs was NP polyps. If the risk score was ≥4, 63.2% of GBPs were NP polyps. ConclusionOur risk scoring system can prevent unnecessary choelcystectomy. Because the incidence of NP polyps in low-risk patients (risk score <4) is extremely rare.

P-BN20 An evaluation of the accuracy of sonography for the measurements of gallbladder polyps across 3 UK hospital trusts: should the surveillance guidelines be revised?

Abstract Background Transabdominal ultrasound scan (USS) is recommended for surveillance of gallbladder polyps (GBP), this is to stratify risk for premalignant potential. European Society of Gastrointestinal and Abdominal Radiology make recommendations based on increases of as small 2mm during sequential USS surveillance. Our aim is to determine the accuracy of USS in diagnosis and measurement of GBP. Methods Measurement data for all GBPs were gathered for three hospital trusts across a 12 year period and retrospectively reviewed. USS findings (diagnosis of GBP and GBP size) were compared with histological diagnosis and measurements, when both reports were available, in those patients who had underwent cholecystectomy at the time of data collection. Results For the first two hospital trusts, 778 USS were reviewed which identified patients with GBP. 78 patients had undergone cholecystectomy at time of data collection. Only 17/78 of patients had histological evidence of GBP. Of those without GBP, 37/61 had gallstones. For the third hospital trust, 41 GBP histological reports were identified, 20 could be directly compared with USS. Collectively 29 USS reports were directly compared with GBP histology reports. Only, 31% had results which were in agreement to within 1mm. The mean measurement discrepancy between both modalities was 5.41mm. Conclusions USS does not provide an accurate diagnosis of GBP, it is likely that USS misdiagnoses gallstones as GBP. Moreover, when comparing USS measurements with histological data, there is 31% accuracy of measurement to within 1mm in this cohort. Current guidelines recommend cholecystectomy if there is an interval change of 2mm or more; this data shows a measurement error of more than this.

Gallbladder Polyp; When Surgical Treatment is Necessary?

Objective: Gallbladder polyps (GBP) are the lesions that are originated from the mucosa of the gallbladder and reach out to the lumen. The biological behaviours of GBP have still been uncertain, their follow-ups and treatments are controversial as they carry the risk of malignancy. Our aim is to present the results of patients who have been operated on with the diagnosis of GBP in this study.Methods: This retrospective study was conducted at Department of General Surgery, Giresun University. Patients who underwent surgery for GBP were included between January 2015 and December 2019. The age, gender, symptoms, ultrasonography findings (numbers polyps, types and presence of polyp and stone), surgery method (open and laparoscopic), and histopathological examination results were analysed.Results: A total of 1486 cholecystectomies, including 1388 laparoscopic cholecystectomy and 98 open cholecystectomies, were performed. One-hundred thirty-two (8.8%) of these patients were operated with the diagnosis of the GBP. One-hundred thirty of them were operated with the laparoscopic method and two of them with the open surgical method. Overall, fourty two (31.8%) of the patients were male and 90 (68.2%) were female. The average age was 48.7. One-hundred one (76.5%) patients were clinically symptomatic. Gallstones were analysed in 35 (26.5%) patients. Multipl polyps were detected in 34 (25.8%) patients. There were no polyps determined in 47 (35.6%) patients the histopathological examination. The most common polyp type was cholesterol polyps (%64.8). Cancer histopathology was not found in any patient.Conclusion: It is difficult to differentiate premalign and/or malignant lesions of the gallbladder from benign lesions. Therefore, we believe that surgical treatment is the correct approach for all GBP, which are symptomatic, accompanying stones, and that have a risk of malignancy ultrasonographically.

Management of gallbladder polyps

SummaryA 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.

What is the accuracy of transabdominal ultrasound (TAUS) or endoscopic ultrasound (EUS) for the diagnosis of gallbladder polyps?

What is the accuracy of transabdominal ultrasound (TAUS) or endoscopic ultrasound (EUS) for the diagnosis of gallbladder polyps?

Deep learning-based decision support system for the diagnosis of neoplastic gallbladder polyps on ultrasonography: Preliminary results

Ultrasonography (US) has been considered image of choice for gallbladder (GB) polyp, however, it had limitations in differentiating between nonneoplastic polyps and neoplastic polyps. We developed and investigated the usefulness of a deep learning-based decision support system (DL-DSS) for the differential diagnosis of GB polyps on US. We retrospectively collected 535 patients, and they were divided into the development dataset (n = 437) and test dataset (n = 98). The binary classification convolutional neural network model was developed by transfer learning. Using the test dataset, three radiologists with different experience levels retrospectively graded the possibility of a neoplastic polyp using a 5-point confidence scale. The reviewers were requested to re-evaluate their grades using the DL-DSS assistant. The areas under the curve (AUCs) of three reviewers were 0.94, 0.78, and 0.87. The DL-DSS alone showed an AUC of 0.92. With the DL-DSS assistant, the AUCs of the reviewer’s improved to 0.95, 0.91, and 0.91. Also, the specificity of the reviewers was improved (65.1–85.7 to 71.4–93.7). The intraclass correlation coefficient (ICC) improved from 0.87 to 0.93. In conclusion, DL-DSS could be used as an assistant tool to decrease the gap between reviewers and to reduce the false positive rate.

Vascular evaluation using transabdominal ultrasound for gallbladder polyps.

Ultrasound (US) is a cost-effective and noninvasive procedure without radiation exposure, with real-time evaluation and high spatial resolution. Although it is useful for the detection of gallbladder (GB) polyps, including gallbladder cancer, adenoma, and benign polyps, conventional US is insufficient for differential diagnosis because it is not capable of evaluating hemodynamic information, unlike computed tomography or magnetic resonance imaging. With recent technological advances in US equipment and contrast agents, Doppler imaging and contrast-enhanced ultrasonography (CEUS) are being used to characterize GB polyps, and several reports on evaluation of the vascularity of GB polyp have been published. In this review, we aimed to report the latest developments in the hemodynamic diagnosis of GB polyps based on previous reports, with an emphasis on CEUS, and to evaluate the efficacy for differential diagnosis. The information in this article is expected to enable early diagnosis and prompt surgical treatment for gallbladder cancer.

The risk of coronary heart disease after diagnosis of gallbladder polyp: a retrospective nationwide population-based cohort study.

To assess the subsequent risk of coronary heart disease (CHD) after the diagnosis of gallbladder polyp (GP). We identified 2,815 GP patients aged ≥20 years from the Longitudinal Health Insurance Database between 2000 and 2011 and followed up the patients until the occurrence of CHD or the end of 2011, the patient would be censored in the occurrence of death, missed information, or withdrawal from the NHI. We selected 11,260 non-GP subjects by 4:1 randomly matching with the case cohort according to age, sex, and index date of GP diagnosis. GP cohort had greater risk of CHD than the control cohort [11.1 vs. 8.07 per 1,000 person-y, adjusted HR (aHR) of 1.28, 95% confidence interval (CI), 1.07-1.53] after adjusting age, sex, hypertension, diabetes, hyperlipidemia, gallstone, chronic obstructive pulmonary disease, and arrhythmia. The risk of CHD was significantly higher in the non-cholecystectomy cohort of GP patients than that in the non-GP cohort (10.9 vs. 8.07 per 1,000 person-y; aHR =1.28; 95% CI, 1.06-1.55). However, the risk of CHD contributed by GP was not significant after cholecystectomy (12.3 vs. 8.07 per 1,000 person-y; aHR =1.24; 95% CI, 0.83-1.85). Compared with the non-GP cohort without hypertension, the risk of CHD increased for GP cohort without (aHR =1.48; 95% CI, 1.18-1.87) or with hypertension (aHR =3.00; 95% CI, 2.30-3.92). Compared with the non-GP cohort without diabetes, the risk of CHD increased for GP cohort without diabetes (aHR =1.46; 95% CI, 1.21-1.76) or with diabetes (aHR =2.07; 95% CI, 1.35-3.18). Compared with the non-GP cohort without hyperlipidemia, the risk of CHD increased for GP cohort without (aHR =1.37; 95% CI, 1.10-1.70) or with hyperlipidemia (aHR =2.63; 95% CI, 2.01-3.44). Compared with the non-GP cohort without arrhythmia, the risk of CHD for GP patients increased without (aHR =1.40; 95% CI, 1.17-1.69) or with arrhythmia (aHR =2.88; 95% CI, 1.82-4.57). GP is associated with increased risk of developing CHD, and the risk increases with the presence of coexisting hypertension, diabetes, hyperlipidemia, or arrhythmia.

New progress of gallbladder polyps imaging diagnosis

Gallbladder polyps is one of the most common diseases in the general surgery. How to get accurate preoperative diagnosis is of great significance for the choice of treatment options. This review summarizes the imaging methods commonly used in preoperative pathological diagnosis of gallbladder polyps, hoping to help clinicians in the development of treatment strategies for gallbladder polyps. Key words: Gallbladder disease; Diagnostic imaging; Gallbladder polyps

The efficacy of real-time colour Doppler flow imaging on endoscopic ultrasonography for differential diagnosis between neoplastic and non-neoplastic gallbladder polyps.

We evaluated the usefulness of real-time colour Doppler flow (CDF) endoscopic ultrasonography (EUS) for differentiating neoplastic gallbladder (GB) polyps from non-neoplastic polyps. Between August 2014 and December 2016, a total of 233 patients with GB polyps who underwent real-time CDF-EUS were consecutively enrolled in this prospective study. CDF imaging was subjectively categorized for each patient as: strong CDF pattern, weak CDF pattern and no CDF pattern. Of the 233 patients, 115 underwent surgical resection. Of these, there were 90 cases of non-neoplastic GB polyps and 23 cases of neoplastic GB polyps. In a multivariate analysis, a strong CDF pattern was the most significant predictive factor for neoplastic polyps; sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 52.2 %, 79.4 %, 38.7 %, 86.9 % and 73.9 %, respectively. Solitary polyp and polyp size were associated with an increased risk of neoplasm. The presence of a strong CDF pattern as well as solitary and larger polyps on EUS may be predictive of neoplastic GB polyps. As real-time CDF-EUS poses no danger to the patient and requires no additional equipment, it is likely to become a supplemental tool for the differential diagnosis of GB polyps. • Differential diagnosis between neoplastic polyps and non-neoplastic polyps of GB is limited. • The use of real-time CDF-EUS was convenient, with high agreement between operators. • The real-time CDF-EUS is helpful in differential diagnosis of GB polyps.

Transabdominal ultrasound or endoscopic ultrasound for diagnosis of gallbladder polyps

Transabdominal ultrasound or endoscopic ultrasound for diagnosis of gallbladder polyps

SONOGRAPHIC CHARACTERISTIC OF GALLBLADDER POLYPS

Objective: To evaluate ultrasound characteristic imaging of gallbladder polyps. And to compare ultrasound imaging with the results of surgery and histopathologyfor positive diagnosis of gallbladder polyps. Subjects and methods: Study on 32 patients (14 male and 18 female, mean age 43,5±18,5 years) with clinical suggestion, ultrasound imaging of gallbladder polyp, and surgery -histopathology positive diagnosis. Cross-sectional descriptive study, from 5/2014 to 3/2015 at the Hospital of Hue Medical and Pharmacy College. Results: Among of 32 patients, 18 patients (56,2%) had results postoperative histopathology of chronic cholecystitis, 14 patients (43,8%) was the type of polyps and adenoma. Thus the specificitive of ultrasound in diagnosis of gallbladder polyps was 43,75% only. Conclusion: The role of ultrasound in diagnosis of gallbladder polyps is the firstscreening for the other indications and ultimate treatment. Key words: ultrasound imaging, histopathology, gallbladder polyps.

Management and diagnosis of gallbladder polyps: a systematic review.

Recommendation for management of gallbladder polyps (GBPs) >1 cm is cholecystectomy. No consensus exists on management of GBPs <1 cm. This systematic review examines current evidence on management of GBPs. MEDLINE, EMBASE and Cochrane library databases were searched from January 1991 to June 2013 using specified terms. A predefined protocol for data extraction was used to retrieve specified end points. Literature search yielded 43 manuscripts with a dataset of 11,685 patients with GBPs. M:F ratio was 1.3:1. Average age (range) was 49 years (32-83). Patients with malignant GBPs had an average (range) age of 58 (50-66) years with M:F ratio of 0.78:1. Cholesterol polyps constituted 60.5% of GBPs followed by adenomas (15.2%) and cancer (11.6%). Malignant GBPs ≥1 cm, <1 cm and <5 mm constituted 8.5, 1.2 and 0% of GBPs, respectively. Majority of patients requiring surgical intervention had laparoscopic cholecystectomy. Presently employed policy of cholecystectomy for GBPs >1 cm is appropriate. For GBPs <1 cm, the authors propose (accepting existence of differing proposals) the following: 1. Surveillance may not be needed for GBPs <5 mm. 2. For GBPs between 5 and 10 mm, two scans at six monthly intervals is suggested and after that, tailor surveillance to age, growth and ethnicity. In the non-Asian population, if GBP remains the same size or number, discontinuation of surveillance may be considered. In the Asian population, if GBPs remain the same, yearly surveillance is continued for a suggested period of 3 years. 3. Discontinue surveillance if GBPs is/are smaller/ disappeared. Cholecystectomy is advised where size increases to >10 mm.

The diagnostic accuracy of transabdominal ultrasonography needs to be considered when managing gallbladder polyps

Transabdominal ultrasonography (TAUS) is the most commonly used modality to diagnose gallbladder (GB) disease. GB polyps are reported in 1-5.6 % of TAUS studies. Histopathologic studies suggest that there is a relationship between GB polyps and GB cancer. Previous literature suggests GB polyps reported on TAUS do not correlate well with histological findings. There have been recent advances in TAUS technology. We hypothesize the recent advances in TAUS technology have improved the accuracy of TAUS for diagnosing GB polyps. Radiology and pathology databases at our tertiary care center were retrospectively searched between January 1, 2000, and December 31, 2010. Ultrasound reports that suggested a GB polyp was present on TAUS were correlated to histopathology in cases where a cholecystectomy was performed. The pathology reports where a GB polyp was found were correlated with preoperative TAUS reports. There were 102,740 TAUS reports referring to the GB, of which 6,612 (6.4 %) contained search terms suggesting a GB polyp was present. There were 13,278 cholecystectomy pathology reports, of which 159 (1.2 %) included a diagnosis of GB polyp. TAUS detected only 50 % of the polyps identified on histopathology. The sensitivity and specificity of TAUS for diagnosing GB polyps were 50.0 and 98.3 %, respectively. The positive and negative predictive values were 10.5 and 99.8 %. Despite improvement in TAUS technology, the accuracy for GB polyps remains poor. This needs to be considered when managing patients with TAUS-detected GB polyps. We recommend that the decision to operate on TAUS-detected GB polyps be largely based on symptoms, and following GB polyps with TAUS should be discouraged.

Surgical Indications in Gallbladder Polyps

IntroductionThe surgery of gallbladder polyps is not well defined due to the lack of evidence-based clinical guidelines. ObjectiveTo analyze the management of polyps in Spain, and a review of the literature and treatment standards. Material and methodsThe reports on cholecystectomy with gallbladder polyps (GBP) were extracted from the Pathology data base. Patients subjected to surgery with a diagnosis of GBP were identified in the Surgery data base. A single list was prepared and a review was made of the clinical histories, including, age, gender, clinical data, ultrasound report, and histopathology report. ResultsA total of 30 patients, with a median age of 51 years (range 22–83), 21 of whom were female, were included. The ultrasound diagnosis was GBP in 19 patients, GBP and calculi in 7 cases, and calculi with no polyps in 4 cases. Other diagnoses concurrent with GBP were multiple haemangiomas (3), large single simple cyst (1), and multiple simple cysts (1). Eleven patients had typical pain (biliary origin), 5 of which showed no calculi on ultrasound. Eight had non-specific pain, which persisted in 3 cases after the cholecystectomy. Pseudopolyps were found in 20 gallbladders, and true polyps in 4 cases. In 3 cases, polyps were not found in the pathology study. ConclusionsThe ultrasound report must specify the size, shape, and number of polyps. Patients with biliary type pain would benefit from a cholecystectomy. The probability of malignancy is minimum if the GBP is less than 10mm and aged under 50 years, and a cholecystectomy is not required. A GBP greater than 10mm should be an indication of cholecystectomy.

The Correlation between Ultrasonography and Histopathology in the Management of Gall Bladder Polyps

Introduction : The diagnosis of gall bladder polyps has increased greatly due to widespread implementation of abdominal ultrasound.Patients and methods : Between February 2005 and February 2010 a total of 39 laparoscopic cholecystectomies were performed for suspected gall bladder polyps. We retrospectively analysed these patients pre-operative ultrasound and histopathology report.Results : The study comprised 10 male and 29 female symptomatic patients with a mean age of 51.4 years. Histo-pathology demonstrated seven true polyps and 23 pseudopolyps. There were no cases of malignant specimens and nine cases of chronic cholecystitis. The positive predictive value (PPV) of ultrasonography for gall bladder polyps was 0.77 and the PPV for true polyps 0.18.Conclusion : PPV for the identification of true gallbladder polyps using ultrasound remains very low at 0.18. We suggest that more advanced imaging modalities are required to improve this figure and enhance patient management.