Current practices and future prospects for the management of gallbladder polyps: A topical review

McCain, R Stephen; Diamond, Anna; Jones, Claire; Coleman, Helen

doi:10.3748/wjg.v24.i26.2844

Cited by 82 publications

(84 citation statements)

References 55 publications

(105 reference statements)

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“…GBPs are elevations of the gallbladder mucosa that protrude into the gallbladder lumen. The estimated prevalence of GBPs in the world is approximately 5% [1]. The incidence of GBPs is approximately 3-7% in abdominal ultrasound scans and 2-12% in cholecystectomy specimens [2].…”

Section: Introductionmentioning

confidence: 99%

Association between the non-HDL-cholesterol-to-HDL-cholesterol ratio and the risk of gallbladder polyp formation among men: a retrospective cohort study

et al. 2020

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Background: Dyslipidaemia and male sex are associated with gallbladder polyp (GBP) formation. However, the potential relation between the non-high-density lipoprotein-cholesterol-to-high-density lipoprotein-cholesterol (non-HDL-c/HDL-c) ratio and GBPs in men is unclear. Methods: A total of 1866 eligible subjects were selected for this retrospective cohort study from Wuhan Union Hospital between April 1, 2013, and November 30, 2014. Clinical and laboratory data of subjects were collected. Patients with GBPs or cholecystectomy at baseline, with missing data for baseline lipid profiles, following abdominal ultrasonography or taking lipid-lowering drugs were excluded. The patients were divided into five groups based on their non-HDL-c/HDL-c ratios, and descriptive analyses of the baseline data were performed. A Cox proportional hazards model was applied to estimate the relationship between the non-HDL-c/HDL-c ratio and GBPs. Results: After a median follow-up of 1 year, 7.34% (n = 137) of the subjects developed GBPs. Compared with subjects without GBPs, those who developed GBPs after follow-up had significantly higher triglyceride (TG) levels and non-HDL-c/HDL-c ratios. The prevalence of GBPs showed a linearity increment with age, peaked in the 30-39 years group, 40-49 years group and 50-59 years group, and then declined slightly. The results of univariate analysis showed that the non-HDL-c/HDL-c ratio (hazard ratio (HR) = 1.29, 95% confidence interval (CI), 1.05-1.60, P = 0.0159) was positively correlated with GBPs. In the fully adjusted Cox regression model, the HRs were 2.24 for quintile 2 (95% CI: 1.13-4.44, P = 0.0203), 1.50 for quintile 3 (95% CI: 0.73-3.10, P = 0.269), 2.52 for quintile 4 (95% CI: 1.26-5.01, P = 0.0087) and 2.13 for quintile 5 (95% CI: 1.04-4.37, P = 0.0397). No interaction was found among the subgroups. Conclusions: A higher non-HDL-c/HDL-c ratio is independently related to a higher risk of GBP formation in Chinese men. Further research is needed to investigate whether this association exists in different regions and races.

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Section: Introductionmentioning

confidence: 99%

Association between the non-HDL-cholesterol-to-HDL-cholesterol ratio and the risk of gallbladder polyp formation among men: a retrospective cohort study

et al. 2020

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“…Additionally, there is potential bias associated with those lost to follow‐up, potentially resulting in an underestimation of GBC risk; however, by analysing the risk per person‐years we have only considered the follow‐up period per patient in which we could account for outcome. While variable imaging modalities were used, abdominal ultrasound is the modality of choice for diagnosis of gallbladder polyps and in our cohort 86% (n = 390) of patients had at least one ultrasound during follow‐up. Other imaging modalities like contrast‐enhanced or endoscopic ultrasound were not used by either centre.…”

Section: Discussionmentioning

confidence: 99%

Risk of gallbladder cancer in patients with primary sclerosing cholangitis and radiographically detected gallbladder polyps

Erp

Cunningham

Narasimman

et al. 2019

Liver International

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Background & Aims Primary sclerosing cholangitis (PSC) is associated with an increased risk of gallbladder cancer (GBC). Gallbladder polyps potentially harbour malignancy and thus international guidelines recommend prophylactic cholecystectomy for gallbladder polyps of any size in patients with PSC. To best inform patient care we sought to quantify the malignant risk of gallbladder polyps in patients with PSC. Methods A retrospective cohort study of patients followed in secondary and tertiary care settings in two large PSC clinics in North America was performed. Results In total, 453 patients were included with a median (IQR) follow‐up time of 7.7 (4.1‐12) years. A gallbladder polyp was radiographically detected in 16% (n = 71) with median size (range) of 4 (2‐18) mm. In this group, post‐cholecystectomy histology (n = 17) reported benign or no polyp in 77% (n = 13), dysplasia in 5.9% (n = 1) and malignancy in 18% (n = 3). The GBC rate was 8.8 (95% CI 1.8‐25.7) per 1000 person‐years in patients with a radiographically detected gallbladder polyp. GBC was associated with polyps >10 mm, interval growth or mass‐like lesions on pre‐operative imaging. In patients who did not have cholecystectomy (n = 50), the polyp was only transiently seen in 80% (n = 40), remained stable or decreased in size in 10% (n = 5) and increased in size in 6% (n = 3). The majority of gallbladder polyps did not show significant growth over time (0.041 mm/year [95% CI −0.017 to 0.249]). Conclusions Most gallbladder polyps in patients with PSC are benign. Short‐term surveillance imaging may be considered prior to recommending immediate cholecystectomy in patients with PSC without high‐risk imaging features.

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“…Laparoscopic cholecystectomy is the standard treatment for patients with symptomatic cholecystolithiasis. Gallbladder polyps are typically lesions in which the gallbladder mucosa protrudes or bulges into the gallbladder cavity, and its prevalence in adults is between 0.3 and 12.3% [ 4 ]. Polyps can be divided into neoplastic and non-neoplastic polyps in terms of pathology, and the main method of radiological diagnosis and monitoring of polyps is abdominal ultrasound.…”

Section: Introductionmentioning

confidence: 99%

Changes in plasma bile acids are associated with gallbladder stones and polyps

Yin-ping

Zhu

et al. 2020

BMC Gastroenterol

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Background The development of gallbladder disease (GBD) is related to bile acid (BA) metabolism, and the rate of BA circulation increases the risk of biliary cancer. However, it is unclear whether patterns of circulating bile acids (BAs) change in patients with benign GBDs such as gallbladder stones and polyps. Herein, we compared and characterised plasma BA profiles in patients with cholecystolithiasis and non-neoplastic polyps with healthy controls, and explored relationships between plasma BA profiles, demographics, and laboratory test indices. Methods A total of 330 subjects (13 healthy controls, 292 cholecystolithiasis and 25 non-neoplastic polyps) were recruited and plasma BA profiles including 14 metabolites from patients with pathologically confirmed cholecystolithiasis and non-neoplastic polyps were compared with controls. BAs were quantitated by liquid chromatography and mass spectrometry, and statistical and regression analyses of demographics and laboratory test indices were performed. Results Females displayed a higher burden of GBD than males (63.36% cholecystolithiasis, 60% non-neoplastic polyps). Cholecystolithiasis and non-neoplastic polyps were associated with increased plasma total secondary BAs, while levels of primary BAs were lower than in healthy controls. Plasma ursodeoxycholic acid (UDCA), tauroursodeoxycholic acid (TUDCA), glycyurdeoxycholic acid (GUDCA), taurochenodeoxycholic acid (TCDCA) and glycochenodeoxycholic acid (GCDCA) were decreased significantly in GBDs, and ursodeoxycholic acid (UDCA) was negatively correlated with white blood cell count and neutrophil percentage. Conclusions Secondary BA levels were higher in patients with cholecystolithiasis and non-neoplastic polyps. White blood cell count and percentage of neutrophil in peripheral blood were negatively correlated with UDCA, indicating an anti-inflammation effect of UDCA.

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Current practices and future prospects for the management of gallbladder polyps: A topical review

Cited by 82 publications

References 55 publications

Association between the non-HDL-cholesterol-to-HDL-cholesterol ratio and the risk of gallbladder polyp formation among men: a retrospective cohort study

Association between the non-HDL-cholesterol-to-HDL-cholesterol ratio and the risk of gallbladder polyp formation among men: a retrospective cohort study

Risk of gallbladder cancer in patients with primary sclerosing cholangitis and radiographically detected gallbladder polyps

Changes in plasma bile acids are associated with gallbladder stones and polyps

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