title: The risk of malignancy in ultrasound detected gallbladder polyps: A systematic review.
abstract: BACKGROUND
  Gallbladder polyps (GBPs) are a common incidental finding on ultrasound (US) examination. The malignant potential of GBPs is debated, and there is limited guidance on surveillance. This systematic review sought to assess the natural history of ultrasonographically diagnosed GBPs and their malignant potential.
  
  
  METHODS
  The keywords: "Gallbladder" AND ("polyp" OR "polypoid lesion") were used to conduct a search in four reference libraries to identify studies which examined the natural history of GBPs diagnosed by US. Twelve studies were eligible for inclusion in this review.
  
  
  RESULTS
  Of the 5482 GBPs reported, malignant GBPs had an incidence of just 0.57%. True GBPs had an incidence of 0.60%. Sixty four patients of adenomatous and malignant polyps were reported. Only in one patient was a malignant GBP reported to be <6mm. Risk factors associated with increased risk of malignancy were GBP >6mm, single GBPs, symptomatic GBPs, age >60 years, Indian ethnicity, gallstones and cholecystitis.
  
  
  CONCLUSIONS
  With the reported incidence of GBP malignancy at just 0.57%, a management approach based on risk assessment, clear surveillance planning, and multi disciplinary team (MDT) discussion should be adopted. The utilization of endoscopic ultrasound(EUS) should be Only considered on the grounds of its greater sensitivity and specificity when compared to US scans.
authors.affiliation: Liverpool Hepatobiliary Centre, University Hospital Aintree, Longmoor Lane, Liverpool L9 7AL, United Kingdom; Institute of Translational Medicine, University of Liverpool, Ashton Street, Liverpool L69 3GE, United Kingdom. Electronic address: Mohamed.elmasry@liverpool.ac.uk.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Elmasry
authors.affiliation: Liverpool University, Brownlow Hill L69 7ZX, United Kingdom.
authors.forename: Don
authors.initials: D
authors.lastname: Lindop
authors.affiliation: Liverpool Hepatobiliary Centre, University Hospital Aintree, Longmoor Lane, Liverpool L9 7AL, United Kingdom; Institute of Translational Medicine, University of Liverpool, Ashton Street, Liverpool L69 3GE, United Kingdom.
authors.forename: Declan F J
authors.initials: DF
authors.lastname: Dunne
authors.affiliation: Liverpool Hepatobiliary Centre, University Hospital Aintree, Longmoor Lane, Liverpool L9 7AL, United Kingdom.
authors.forename: Hassan
authors.initials: H
authors.lastname: Malik
authors.affiliation: Liverpool Hepatobiliary Centre, University Hospital Aintree, Longmoor Lane, Liverpool L9 7AL, United Kingdom.
authors.forename: Graeme J
authors.initials: GJ
authors.lastname: Poston
authors.affiliation: Liverpool Hepatobiliary Centre, University Hospital Aintree, Longmoor Lane, Liverpool L9 7AL, United Kingdom.
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Fenwick
mesh_terms: D002763:Cholecystectomy; D005706:Gallbladder Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D006801:Humans; D011127:Polyps / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D012307:Risk Factors; D014463:Ultrasonography
keywords: Gallbladder cancer; Gallbladder polyps