Risk factors for gallbladder polyps observed through second-look abdominal sonography in patients with fatty liver disease

Lin, Shu-Hsien; Wu, Kun-Ta; Chiu, Yi‐Chun; Wang, Chih‐Chi; Chiu, King-Wah

doi:10.1097/md.0000000000029643

Cited by 2 publications

(3 citation statements)

References 30 publications

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“…Thus, they stressed that plain abdominal preoperative US alone may not be reliable for diagnosing GB polyps. [62] Similar allegations for the reliability of US alone have been formulated by Lodhi et al, who recommend following MRI. [25] It has been reported that GB polyps may be detected on US during a second look in cases of fatty liver disease, older age and alcohol consumption, where there are imaging difficulties.…”

Section: Diagnosismentioning

confidence: 81%

Contemporary diagnosis and management of gallbladder polyps

Pavlidis,

Galanis,

Pavlidis

2023

Gastroenterol Funct Med

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Gallbladder (GB) polyps are present in 5%–10% of the general population and consist of true neoplastic polyps (adenomas) and pseudopolyps (predominantly cholesterol, inflammatory, hyperplastic, focal adenomyomatosis). True polyps, although relatively rare neoplastic lesions (0.5%) are considered an important factor in malignant transformation and cancer development (5%) when their size is ≥ 1 cm. Given that it is essential to diagnose GB adenocarcinoma at an early stage to optimize therapeutic management, controversy exists about whether cholecystectomy is always necessary. Their imaging characteristics, size ≥ 1 cm, age > 50 years and genetic predisposition determine the indications for immediate cholecystectomy. In younger patients with polyps < 1 cm in size and without a familial history of GB carcinoma, imaging follow-up by ultrasound (US) seems to be a reasonable recommended policy. A scoring system by multivariate analysis (cross-sectional area > 123 mm2, positive blood flow signal, age > 55.5 years, alanine aminotransferase (ALT) levels > 50 U/L and an ALT/AST (aspartate aminotransferase) ratio > 0.77) can accurately predict true polyps. The widely accepted size threshold for US follow-up is 7 mm, and for intervention, it is 10 mm. Computed tomography or better magnetic resonance imaging can overcome any misdiagnosis of conventional US incidental findings alone that may lead to potentially unnecessary operations. In challenging cases, high-resolution US, novel three-dimensional US, endoscopic US or contrast-enhanced endoscopic US could be helpful. Novel microflow imaging can safely predict polyps. Risk factors for malignancy include age > 60 years, large gallstones, primary sclerosing cholangitis, Asian ethnicity and sessile polyps accompanied by focal gallbladder wall thickening > 4 mm. For polyps sized 6–9 mm, the absence of growth at recommended follow-up (6 months, one year, and two years) indicates treatment discontinuation; however, it is not required for size < 5 mm without risk factors. In addition to laparoscopic cholecystectomy, the standard management, novel interventional modalities preserving the GB in selected cases include per-oral transmural endoscopic resection of GB polyps after a bridge of endoscopic US-guided cholecystostomy or laparoscopic gallbladder-preserving polypectomy. Generally, there are still no precise and strong evidence-based guidelines; thus, the management policy of GB polyps should be individualized in ambiguous cases.

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Section: Diagnosismentioning

confidence: 81%

Contemporary diagnosis and management of gallbladder polyps

Pavlidis,

Galanis,

Pavlidis

2023

Gastroenterol Funct Med

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Section: Introductionmentioning

confidence: 99%

“…Blood alcohol stimulates cholecystokinin secretion in the pancreas, counteracting cholesterol GBP formation by increasing gallbladder motility [16,17]. However, a Taiwanese group demonstrated alcohol consumption to be an independent risk factor for GBP [18]. Well-known risk factors for GBP development and progression include the male sex, age, dyslipidemia, and non-alcoholic fatty liver disease [1,8,9].…”

Section: Introductionmentioning

confidence: 99%

Retrospective Study of the Prevalence and Associated Factors of Gallbladder Polyps among Residents of Two Korean Cities

Kwon,

Kim,

Kim

2024

JCM

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Background/Aims: Well-known risk factors for gallbladder polyps include metabolic syndrome, age, and dyslipidemia. Jeju Island is approximately 80 km from the Korean peninsula and is divided into two administrative regions (Jeju City and Seogwipo City), with Mount Halla intervening in the center. Jeju City has higher employment and birth rates than Seogwipo City. Age and alcohol consumption differ between the two regions, and these factors may affect the prevalence of gallbladder polyps (GBPs). Therefore, we investigated the prevalence of GBPs and compared various factors, including alcohol consumption habits and age, associated with GBPs among residents in the two regions. Methods: This study included 21,734 residents who visited the Health Screening and Promotion Center of Jeju National University Hospital between January 2009 and December 2019. We investigated the prevalence and associated factors of GBPs among residents of Jeju City and Seogwipo City. Results: The prevalence of GBPs in Jeju City and Seogwipo City was 9.8% and 8.9% (p = 0.043), respectively. The mean age and rate of high-risk alcohol intake were higher in Seogwipo City. The mean body mass index and levels of fasting blood glucose, total cholesterol, low-density lipoprotein cholesterol, aspartate aminotransferase, gamma-glutamyl transferase, and alkaline phosphatase were lower in Jeju City. Conclusions: This study demonstrated a significant difference in GBP prevalence between the two regions of Jeju Island. Age and alcohol consumption might contribute to this difference; however, further prospective cohort studies are warranted to confirm our findings.

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Risk factors for gallbladder polyps observed through second-look abdominal sonography in patients with fatty liver disease

Cited by 2 publications

References 30 publications

Contemporary diagnosis and management of gallbladder polyps

Contemporary diagnosis and management of gallbladder polyps

Retrospective Study of the Prevalence and Associated Factors of Gallbladder Polyps among Residents of Two Korean Cities

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