Two 5mm gallbladder polyps are identified on the ultrasound of a 67yr old lady. What is the most appropriate management?
No follow-up | |
Follow-up ultrasound in 3 months | |
Follow-up ultrasound in 6 months | |
Cross sectional imaging | |
Referral for cholecystectomy |
Gallbladder polyps are common (5% of people), and typically appear as non-shadowing immobile lesions attached to the gallbladder wall.
Although individual institutional practices may vary, a retrospective analysis in Radiology from 2011 did not find cancer in polyps less than 6mm. Their conclusion was that these small lesions should be left without follow-up. The presence of more than one lesion (as in this case) reduces the risk of malignancy even further. Single polyps that are larger than this should probably be followed up, and those greater than a centimetre may want to be considered for cholecystectomy.
References
Incidentally Detected Gallbladder Polyps: Is Follow-up Necessary?—Long-term Clinical and US Analysis of 346 Patients: http://pubs.rsna.org/doi/full/10.1148/radiol.10100273