Mike van Dooren, Elise A J de Savornin Lohman, Jarmila van der Bilt, Marieke T de Boer, Djamila Boerma, Philip Bos, Andries E Braat, Steve M M de Castro, Bartholomeus J G A Corten, Freek Daams, Joris I Erdmann, Floris Ferenschild, Ansje S Fortuin, Nanette van Geloven, Erik van der Hoeven, Rutger Klicks, Flip M Kruyt, Barbara S Langenhoff, Mike S L Liem, Philip V M Linsen, Misha Luyer, Vincent B Nieuwenhuijs, Pim Olthof, Peter W Plaisier, Charles van Rossem, Ruud Schrauwen, Jennifer Schreinemakers, Gian Piero Serafino, Ernst Jan Spillenaar Bilgen, Koen Talsma, Merel M Tielemans, Charlotte J Tutein Nolthenius, Philip de Reuver
{"title":"修订后的胆囊息肉治疗和随访指南不能减少不必要的胆囊切除术：息肉研究的结果。","authors":"Mike van Dooren, Elise A J de Savornin Lohman, Jarmila van der Bilt, Marieke T de Boer, Djamila Boerma, Philip Bos, Andries E Braat, Steve M M de Castro, Bartholomeus J G A Corten, Freek Daams, Joris I Erdmann, Floris Ferenschild, Ansje S Fortuin, Nanette van Geloven, Erik van der Hoeven, Rutger Klicks, Flip M Kruyt, Barbara S Langenhoff, Mike S L Liem, Philip V M Linsen, Misha Luyer, Vincent B Nieuwenhuijs, Pim Olthof, Peter W Plaisier, Charles van Rossem, Ruud Schrauwen, Jennifer Schreinemakers, Gian Piero Serafino, Ernst Jan Spillenaar Bilgen, Koen Talsma, Merel M Tielemans, Charlotte J Tutein Nolthenius, Philip de Reuver","doi":"10.1002/ueg2.70057","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Gallbladder polyps are seen in up to 7% of adults and carry a low malignancy risk. Guidelines on indication for surgery and follow-up remain controversial because of regional differences in the development of malignancy. This study compares European practice guidelines for gallbladder polyps and assesses the percentage of patients in whom cholecystectomy was indicated according to the guidelines with a true adenoma postoperatively.</p><p><strong>Methods: </strong>Dutch patients with active follow-up or surgery for gallbladder polyps between 2018 and 2020 in 26 participating centres were included. Data on demographics, imaging characteristics, surgery and histopathology were assessed. Indications for cholecystectomy were examined for all patients comparing 2017 and 2022 European guidelines.</p><p><strong>Results: </strong>A cohort of 302 patients was included. Patients in follow-up underwent imaging three times (median) and were followed up during a median of 23.2 months (IQR 10.9-47.4). In total, 88 patients (29%) underwent cholecystectomy after a median period of 23 months and a median of two instances of imaging. In 71 of 88 patients (81%) who underwent cholecystectomy, the gallbladder polyps was a valid indication for cholecystectomy according to 2017 guidelines, compared to 68 of 88 (77%) according to 2022 guidelines. The difference only occurred due to age as a risk factor which changed from 50 to 60 years of age. Of 71 operated patients, non-neoplastic polyps were found in 49 (69%), no gallbladder wall abnormality was found in 23 (32%). An adenoma was found in six patients (9%), of which three had low grade dysplasia and one had high grade dysplasia.</p><p><strong>Discussion: </strong>Despite revision of guidelines in 2022, a significant number of patients still undergo follow-up and cholecystectomy for non-neoplastic gallbladder polyps, indicating the need for a more comprehensive risk assessment algorithm in the management of gallbladder polyps.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"1133-1140"},"PeriodicalIF":6.7000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463707/pdf/","citationCount":"0","resultStr":"{\"title\":\"Revised Guidelines for the Treatment and Follow-Up of Gallbladder Polyps Do Not Reduce Unwarranted Cholecystectomies: Results of the POLYP Study.\",\"authors\":\"Mike van Dooren, Elise A J de Savornin Lohman, Jarmila van der Bilt, Marieke T de Boer, Djamila Boerma, Philip Bos, Andries E Braat, Steve M M de Castro, Bartholomeus J G A Corten, Freek Daams, Joris I Erdmann, Floris Ferenschild, Ansje S Fortuin, Nanette van Geloven, Erik van der Hoeven, Rutger Klicks, Flip M Kruyt, Barbara S Langenhoff, Mike S L Liem, Philip V M Linsen, Misha Luyer, Vincent B Nieuwenhuijs, Pim Olthof, Peter W Plaisier, Charles van Rossem, Ruud Schrauwen, Jennifer Schreinemakers, Gian Piero Serafino, Ernst Jan Spillenaar Bilgen, Koen Talsma, Merel M Tielemans, Charlotte J Tutein Nolthenius, Philip de Reuver\",\"doi\":\"10.1002/ueg2.70057\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Gallbladder polyps are seen in up to 7% of adults and carry a low malignancy risk. Guidelines on indication for surgery and follow-up remain controversial because of regional differences in the development of malignancy. This study compares European practice guidelines for gallbladder polyps and assesses the percentage of patients in whom cholecystectomy was indicated according to the guidelines with a true adenoma postoperatively.</p><p><strong>Methods: </strong>Dutch patients with active follow-up or surgery for gallbladder polyps between 2018 and 2020 in 26 participating centres were included. Data on demographics, imaging characteristics, surgery and histopathology were assessed. Indications for cholecystectomy were examined for all patients comparing 2017 and 2022 European guidelines.</p><p><strong>Results: </strong>A cohort of 302 patients was included. Patients in follow-up underwent imaging three times (median) and were followed up during a median of 23.2 months (IQR 10.9-47.4). In total, 88 patients (29%) underwent cholecystectomy after a median period of 23 months and a median of two instances of imaging. In 71 of 88 patients (81%) who underwent cholecystectomy, the gallbladder polyps was a valid indication for cholecystectomy according to 2017 guidelines, compared to 68 of 88 (77%) according to 2022 guidelines. The difference only occurred due to age as a risk factor which changed from 50 to 60 years of age. Of 71 operated patients, non-neoplastic polyps were found in 49 (69%), no gallbladder wall abnormality was found in 23 (32%). An adenoma was found in six patients (9%), of which three had low grade dysplasia and one had high grade dysplasia.</p><p><strong>Discussion: </strong>Despite revision of guidelines in 2022, a significant number of patients still undergo follow-up and cholecystectomy for non-neoplastic gallbladder polyps, indicating the need for a more comprehensive risk assessment algorithm in the management of gallbladder polyps.</p>\",\"PeriodicalId\":23444,\"journal\":{\"name\":\"United European Gastroenterology Journal\",\"volume\":\" \",\"pages\":\"1133-1140\"},\"PeriodicalIF\":6.7000,\"publicationDate\":\"2025-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463707/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"United European Gastroenterology Journal\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/ueg2.70057\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/7/23 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"United European Gastroenterology Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/ueg2.70057","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/7/23 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
Revised Guidelines for the Treatment and Follow-Up of Gallbladder Polyps Do Not Reduce Unwarranted Cholecystectomies: Results of the POLYP Study.
Background: Gallbladder polyps are seen in up to 7% of adults and carry a low malignancy risk. Guidelines on indication for surgery and follow-up remain controversial because of regional differences in the development of malignancy. This study compares European practice guidelines for gallbladder polyps and assesses the percentage of patients in whom cholecystectomy was indicated according to the guidelines with a true adenoma postoperatively.
Methods: Dutch patients with active follow-up or surgery for gallbladder polyps between 2018 and 2020 in 26 participating centres were included. Data on demographics, imaging characteristics, surgery and histopathology were assessed. Indications for cholecystectomy were examined for all patients comparing 2017 and 2022 European guidelines.
Results: A cohort of 302 patients was included. Patients in follow-up underwent imaging three times (median) and were followed up during a median of 23.2 months (IQR 10.9-47.4). In total, 88 patients (29%) underwent cholecystectomy after a median period of 23 months and a median of two instances of imaging. In 71 of 88 patients (81%) who underwent cholecystectomy, the gallbladder polyps was a valid indication for cholecystectomy according to 2017 guidelines, compared to 68 of 88 (77%) according to 2022 guidelines. The difference only occurred due to age as a risk factor which changed from 50 to 60 years of age. Of 71 operated patients, non-neoplastic polyps were found in 49 (69%), no gallbladder wall abnormality was found in 23 (32%). An adenoma was found in six patients (9%), of which three had low grade dysplasia and one had high grade dysplasia.
Discussion: Despite revision of guidelines in 2022, a significant number of patients still undergo follow-up and cholecystectomy for non-neoplastic gallbladder polyps, indicating the need for a more comprehensive risk assessment algorithm in the management of gallbladder polyps.
期刊介绍：
United European Gastroenterology Journal (UEG Journal) is the official Journal of the United European Gastroenterology (UEG), a professional non-profit organisation combining all the leading European societies concerned with digestive disease. UEG’s member societies represent over 22,000 specialists working across medicine, surgery, paediatrics, GI oncology and endoscopy, which makes UEG a unique platform for collaboration and the exchange of knowledge.
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