• Skip to primary navigation
  • Skip to main content
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Advocacy
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • SAGES Store
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
    • “Unofficial” Logo Products
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2024 Scientific Session Call For Abstracts
      • 2024 Emerging Technology Call For Abstracts
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Fellows Career Development Course
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • NEW-Area of Concentrated Training Seal (ACT)-Advanced Flexible Endoscopy
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Multi-Society Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • OWLS
  • Log In

The diagnsotic accuracy of transabdominal ultrasonography needs to be considered when managing gallbladder polyps

Daniel French, Phil Allen, James Ellsmere

Division of General Surgery, QEII Health Sciences Centre, Dalhousie University, Halifax NS

Introduction: Transabdominal ultrasonography (US) is the most commonly used test to diagnosis gallbladder disease. Gallbladder (GB) polyps are reported in 1-5.6% of US studies. Histopathologic studies suggest there is a relationship between GB polyps and GB cancer. GB cancer has a 5-survival of less than 5% because patients are often asymptomatic until the cancer is at advanced stage. GB polyps reported on US do not correlate well with histological findings and the eventual development of GB cancer. The standard recommendation for GB polyps detected on US that are greater than 6-10 mm is cholecystectomy. Surveillance with US is recommended for smaller polyps. Recent advances in US technology may impact these recommendations. We hypothesize the recent advances in US technology has improved the accuracy of transabdominal US for diagnosing GB polyps.

Methods: Between January 1, 2000 and December 31, 2010, 102,740 transabdominal US were performed in our tertiary teaching hospital and there were 6,612 GB polyps reported. During the same time period, 13,703 cholecystectomies were performed. There were 229 patients who underwent cholecystectomy who also had a GB polyp identified on a preoperative US. Histopathologic correlation study was performed to assess the diagnostic accuracy for transabdominal US.

Results: GB polyps were found in 6.4% of transabdominal US reports. Polyps were found in 1.2% of cholecystectomy specimens. US detected only 50% of the polyps identified on histopathology. The table lists the histopathology for the 229 patients undergoing cholecystectomy with a preoperative diagnosis of a GB polyp.

Histopathology Number Incidence(%)
Normal GB 8 3.4
Cholecystitis,Chronic 175 76.4
Cholelithiasis 115 50.2
Cholesterolosis 82 35.8
Cholecystitis,Acute 20 8.7
Adenomyomatosis 3 3.1
Adenomyoma 7 3.1
Cholesterol Polyp 17 7.4
Hyperplastic Polyp 4 1.7
Adenoma 2 0.9
All Polyps 23 10.5
Malignancy 3 1.3

Of the polyps found on US, 89.5% were not found on histopathology. Of the 23 polypoid lesions correctly detected by ultrasound there were 17 cholesterol polyps, 4 hyperplastic polyps, and 2 adenomas.

The sensitivity and specificity of transabdominal US for diagnosing GB polyps were 50.0 and 98.3%, respectively. The positive and negative predictive values were 10.5 and 99.8%.

Conclusion: Despite improvement in US technology, the accuracy of transabdominal ultrasonography for GB polyps remains poor. This needs to be considered when managing patients with US detected GB polyps. We recommend that the decision to operate on US detected GB polyps be largely based on symptoms and following GB polyps with US should be discouraged.


Session: Podium Presentation

Program Number: S002

76

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

Hours & Info

11300 West Olympic Blvd, Suite 600
Los Angeles, CA 90064
1-310-437-0544
[email protected]
Monday - Friday
8am to 5pm Pacific Time

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2023 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2023 Society of American Gastrointestinal and Endoscopic Surgeons