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담낭 용종의 진단, 치료 및 추적 관찰의 최신 지견

Recent Updates on Diagnosis, Treatment, and Follow-up of Gallbladder Polyps

대한소화기학회지 2020년 76권 3호 p.102 ~ 107
장성일, 조재희, 이동기,
소속 상세정보
장성일 ( Jang Sung-Ill ) - Yonsei University College of Medicine Gangnam Severance Hospital Department of Internal Medicine
조재희 ( Cho Jae-Hee ) - Yonsei University College of Medicine Gangnam Severance Hospital Department of Internal Medicine
이동기 ( Lee Dong-Ki ) - Yonsei University College of Medicine Gangnam Severance Hospital Department of Internal Medicine

Abstract


A gallbladder (GB) polyp is an elevation of the GB mucosa that protrudes into the GB lumen. GB polyps have an estimated prevalence of 0.3-9.5% and can be divided into neoplastic (true) polyps and nonneoplastic polyps (pseudopolyps). Pseudopolyps are most commonly cholesterol polyps but also include focal adenomyomatosis and inflammatory polyps with no malignant potential. Neoplastic polyps, however, can be benign or malignant. Benign polyps are most commonly adenomas, while malignant polyps are usually adenocarcinoma. Transabdominal ultrasonography is the main radiological modality used for diagnosing and surveilling GB polyps. On the other hand, because it is difficult to diagnose GB polyps before surgery, alternative imaging modalities, such as endoscopic ultrasound, are being further evaluated. The current guidelines recommend cholecystectomy for GB polyps ≥ 10 mm in size as well as suboptimal sized GB polyps (6-9 mm) with other risk factors, including age >50, sessile, and symptoms. The quality of the evidence behind this practice is relatively low. Therefore, this review identifies the current gaps in the available evidence and guidelines and introduces methods that can help make decisions regarding patients who require a cholecystectomy or follow-up.

키워드

Gallbladder polyp; Gallbladder diseases; Gallbladder neoplasms; Diagnosis; Therapy

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