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Congress: ECR25
Poster Number: C-22282
Type: Poster: EPOS Radiologist (educational)
Authorblock: M. B. Sacramento, R. A. Trovisco, P. Rocha, J. P. Leite, L. H. C. B. Samouco; Porto/PT
Disclosures:
Maria Beatriz Sacramento: Nothing to disclose
Rita Andrade Trovisco: Nothing to disclose
Pedro Rocha: Nothing to disclose
João Pedro Leite: Nothing to disclose
Lúcia Helena Carvalho Boavista Samouco: Nothing to disclose
Keywords: Abdomen, Biliary Tract / Gallbladder, Ultrasound, Diagnostic procedure, Education and training, Outcomes, Patterns of Care
Learning objectives Review the most recent guidelines for managing incidentally detected gallbladder polyps. Compare the 2021 updated 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) with the 2022 Society of Radiologists in Ultrasound (SRU) gallbladder polyp consensus guidelines. Understand the common imaging findings associated with this condition.
Read more Background Gallbladder polyps (GP), defined as outgrowths of the gallbladder wall (Figure 1), are a common incidental finding on trans-abdominal ultrasound (TAUS). They carry a wide differential diagnosis, including benign and malignant tumors, and pseudotumors, also called benign non-neoplastic polyps (e.g., cholesterol polyps, adenomyomatosis, and inflammatory polyps). [fig 1] Although their estimated prevalence is 3-7% in the general population [1], gallbladder cancer (GBC) is a relatively infrequent diagnosis. While detection of malignancy at an early stage of disease is crucial to improve survival rates,...
Read more Findings and procedure details As stated by the updated joint guidelines between the ESGAR, EAES, EFISDS, and ESGE, the primary investigation of GPs should be with TAUS, as it is a highly repeatable and reproducible technique available in all radiology departments [3]. Alternative imaging modalities may be useful to aid decision-making in some cases. The SRU consensus conference guidelines [4] include a recommendation on the use of Color Doppler Ultrasound in a short interval follow-up if an evaluation is considered technically inadequate or if...
Read more Conclusion The management and follow-up of gallbladder polyps differ significantly between American and European guidelines. The SRU recommendations favor a more conservative, descriptive, and practical strategy, with higher thresholds for surgery and fewer factors to consider when planning the next steps in GP management. The European joint guidelines, on the other hand, suggest a more individualized and preventive approach, considering a lower threshold for cholecystectomy, which can sometimes be interpreted as aggressive and unnecessary.Although the American recommendations may look appealing because...
Read more References [1] Chatterjee A, Lopes Vendrami C, Nikolaidis P et al. Uncommon Intraluminal Tumors of the Gallbladder and Biliary Tract: Spectrum of Imaging Appearances. Radiographics. 2019;39(2):388-412. doi:10.1148/rg.2019180164[2] Adsay V, Jang KT, Roa JC, et al. Intracholecystic papillary-tubular neoplasms (ICPN) of the gallbladder (neoplastic polyps, adenomas, and papillary neoplasms that are ≥1.0 cm): clinicopathologic and immunohistochemical analysis of 123 cases. Am J Surg Pathol 2012;36(9):1279–1301.[3] Foley, K. G., Lahaye, M. J., Thoeni, R. F., Soltes, M., Dewhurst, C., Barbu, S. T., Vashist,...
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