European ultrasound guidelines on gallbladder polyps are "likely too conservative," according to a study published on 22 September in the American Journal of Roentgenology.
European guidelines recommend follow-up imaging for gallbladder polyps (including polyps < 6 mm in patients without risk factors) and a size change of more than 2 mm indicating a patient should be sent on for cholecystectomy. But this recommendation is so conservative that it covers essentially all polyps, according to a team led by Dr. Andrew Walsh from Stanford University.
Walsh and colleagues studied patients who underwent at least one screening ultrasound examination between January 2010 and December 2020, as part of a hepatocellular carcinoma screening and surveillance program.
Among the 434 patients (248 male, 186 female; average age, 50.6) with incidental gallbladder polyps who underwent serial ultrasound examinations for HCC surveillance, the polyps fluctuated in number in 22% and in size in 18% of patients. No gallbladder carcinoma was identified in the 19 patients who underwent cholecystectomy.