@article{Foley20223358,

title = {Management and follow-up of gallbladder polyps: updated joint guidelines between the ESGAR, EAES, EFISDS and ESGE},

author = {Kieran G. Foley and Max J. Lahaye and Ruedi F. Thoeni and Marek Soltes and Catherine Dewhurst and Sorin Traian Barbu and Yogesh K. Vashist and Søren Rafael Rafaelsen and Marianna Arvanitakis and Julie Perinel and Rebecca Wiles and Stuart Ashley Roberts},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85121354313&doi=10.1007%2fs00330-021-08384-w&partnerID=40&md5=e244dfb80a773d07ec752c3661bc2cd6},

doi = {10.1007/s00330-021-08384-w},

issn = {09387994},

year  = {2022},

date = {2022-01-01},

urldate = {2022-01-01},

journal = {European Radiology},

volume = {32},

number = {5},

pages = {3358 – 3368},

publisher = {Springer Science and Business Media Deutschland GmbH},

abstract = {Abstract: Main recommendations: 1.Primary investigation of polypoid lesions of the gallbladder should be with abdominal ultrasound. Routine use of other imaging modalities is not recommended presently, but further research is needed. In centres with appropriate expertise and resources, alternative imaging modalities (such as contrast-enhanced and endoscopic ultrasound) may be useful to aid decision-making in difficult cases. Strong recommendation, low–moderate quality evidence.2.Cholecystectomy is recommended in patients with polypoid lesions of the gallbladder measuring 10 mm or more, providing the patient is fit for, and accepts, surgery. Multidisciplinary discussion may be employed to assess perceived individual risk of malignancy. Strong recommendation, low-quality evidence.3.Cholecystectomy is suggested for patients with a polypoid lesion and symptoms potentially attributable to the gallbladder if no alternative cause for the patient’s symptoms is demonstrated and the patient is fit for, and accepts, surgery. The patient should be counselled regarding the benefit of cholecystectomy versus the risk of persistent symptoms. Strong recommendation, low-quality evidence.4.If the patient has a 6–9 mm polypoid lesion of the gallbladder and one or more risk factors for malignancy, cholecystectomy is recommended if the patient is fit for, and accepts, surgery. These risk factors are as follows: age more than 60 years, history of primary sclerosing cholangitis (PSC), Asian ethnicity, sessile polypoid lesion (including focal gallbladder wall thickening > 4 mm). Strong recommendation, low–moderate quality evidence.5.If the patient has either no risk factors for malignancy and a gallbladder polypoid lesion of 6–9 mm, or risk factors for malignancy and a gallbladder polypoid lesion 5 mm or less, follow-up ultrasound of the gallbladder is recommended at 6 months, 1 year and 2 years. Follow-up should be discontinued after 2 years in the absence of growth. Moderate strength recommendation, moderate-quality evidence.6.If the patient has no risk factors for malignancy, and a gallbladder polypoid lesion of 5 mm or less, follow-up is not required. Strong recommendation, moderate-quality evidence.7.If during follow-up the gallbladder polypoid lesion grows to 10 mm, then cholecystectomy is advised. If the polypoid lesion grows by 2 mm or more within the 2-year follow-up period, then the current size of the polypoid lesion should be considered along with patient risk factors. Multidisciplinary discussion may be employed to decide whether continuation of monitoring, or cholecystectomy, is necessary. Moderate strength recommendation, moderate-quality evidence.8.If during follow-up the gallbladder polypoid lesion disappears, then monitoring can be discontinued. Strong recommendation, moderate-quality evidence. Source and scope: These guidelines are an update of the 2017 recommendations developed 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). A targeted literature search was performed to discover recent evidence concerning the management and follow-up of gallbladder polyps. The changes within these updated guidelines were formulated after consideration of the latest evidence by a group of international experts. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) system was adopted to define the strength of recommendations and the quality of evidence. Key Point: • These recommendations update the 2017 European guidelines regarding the management and follow-up of gallbladder polyps. © 2021, The Author(s).},

note = {Cited by: 7; All Open Access, Green Open Access, Hybrid Gold Open Access},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Patel2019636,

title = {Five year experience of gallbladder polyp surveillance and cost effective analysis against new European consensus guidelines},

author = {Krashna Patel and Khaled Dajani and Saranya Vickramarajah and Emmanuel Huguet},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85056202258&doi=10.1016%2fj.hpb.2018.10.008&partnerID=40&md5=e4ce94e3f52f86eafb852c2ebab999e4},

doi = {10.1016/j.hpb.2018.10.008},

issn = {1365182X},

year  = {2019},

date = {2019-01-01},

urldate = {2019-01-01},

journal = {HPB},

volume = {21},

number = {5},

pages = {636 – 642},

publisher = {Elsevier B.V.},

abstract = {Background: Gallbladder polyp (GBP) surveillance seeks to identify early neoplasms, but practice varies amongst surgical units. Recent European consensus guidelines have recommended an evidence-based GBP surveillance strategy. In a tertiary centre Hepato-Pancreato-Biliary unit we examine GBP surveillance, malignant yield, and assess cost-effectiveness of the new European consensus guidelines. Methods: Respective data were collected from all patients with ultrasonography-detected GBPs between January 2008 and January 2013. Results: 558 patients had GBPs detected on ultrasonography. Following initial ultrasonography, 304 (54.5%) had further ultrasonography surveillance of which 168 were in a formal GBP surveillance programme. Pre-malignant/malignant pathology yield was 1.97% with an annual detection rate of 12.0 cases per 1000 GBPs surveyed. Cost-effectiveness analysis of European consensus guidelines calculated annual savings of £209 163 per 1000 GBPs surveyed. Compliance with these guidelines would result in an additional 12.5% of patients under surveillance requiring cholecystectomy. Conclusion: GBP surveillance uptake was suboptimal at 32.8%. The incidence of pre-malignant/malignant lesions in GBPs emphasises the importance of surveillance for early detection and management with a view to avoiding the poor outcomes associated with more advanced gallbladder cancer. Adherence to the new European consensus guidelines would be clinically cost-effective with significant potential savings demonstrated in this study. © 2018 International Hepato-Pancreato-Biliary Association Inc.},

note = {Cited by: 8; All Open Access, Bronze Open Access},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Wiles20173856,

title = {Management and follow-up of gallbladder polyps: 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)},

author = {Rebecca Wiles and Ruedi F. Thoeni and Sorin Traian Barbu and Yogesh K. Vashist and Søren Rafael Rafaelsen and Catherine Dewhurst and Marianna Arvanitakis and Max Lahaye and Marek Soltes and Julie Perinel and Stuart Ashley Roberts},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85011826986&doi=10.1007%2fs00330-017-4742-y&partnerID=40&md5=4d7ae172ad6f7f9639af4101bb98ec5d},

doi = {10.1007/s00330-017-4742-y},

issn = {09387994},

year  = {2017},

date = {2017-01-01},

urldate = {2017-01-01},

journal = {European Radiology},

volume = {27},

number = {9},

pages = {3856 – 3866},

publisher = {Springer Verlag},

abstract = {Objectives: The management of incidentally detected gallbladder polyps on radiological examinations is contentious. The incidental radiological finding of a gallbladder polyp can therefore be problematic for the radiologist and the clinician who referred the patient for the radiological examination. To address this a joint guideline was created by 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). Methods: A targeted literature search was performed and consensus guidelines were created using a series of Delphi questionnaires and a seven-point Likert scale. Results: A total of three Delphi rounds were performed. Consensus regarding which patients should have cholecystectomy, which patients should have ultrasound follow-up and the nature and duration of that follow-up was established. The full recommendations as well as a summary algorithm are provided. Conclusions: These expert consensus recommendations can be used as guidance when a gallbladder polyp is encountered in clinical practice. Key Points: • Management of gallbladder polyps is contentious • Cholecystectomy is recommended for gallbladder polyps >10 mm • Management of polyps <10 mm depends on patient and polyp characteristics • Further research is required to determine optimal management of gallbladder polyps. © 2017, The Author(s).},

note = {Cited by: 120; All Open Access, Green Open Access, Hybrid Gold Open Access},

keywords = {},

pubstate = {published},

tppubtype = {article}

}