A comparison of society guidelines in the management of gallbladder polyps.

BACKGROUND

In 2021, European radiology and gastrointestinal societies updated their guidelines regarding the management of gallbladder polyps (GBP). In 2022, the Society of Radiologists in Ultrasound (SRU) also released their guidelines. We compared the two sets to determine the differences in management and outcomes for GBPs.

METHODS

We performed a retrospective analysis from 2018 to 2023 of 118 patients referred for GBPs. Radiologists retrospectively reviewed patient ultrasounds (US) and assigned an SRU category. We applied both sets of guidelines to identify next recommended step and performed a cost analysis.

RESULTS

When applying European versus SRU guidelines, 52.5 ​% (n ​= ​62) versus 16.9 ​% (n ​= ​20) would have undergone immediate surgery (p ​< ​0.0001). US would have been considered a reasonable next step in 28.8 ​% (n ​= ​34) vs 42.4 ​% (n ​= ​50) (p ​= ​0.03). Adherence to SRU guidelines would have resulted in $1837 less spent per person (p ​< ​0.001).

CONCLUSION

Our findings found that adherence to SRU guidelines leads to less surgeries and follow up compared to European guidelines without causing harm. Further studies should be done to validate these findings and support standardized reporting of GBP.