University of Twente Student Theses
The POLYP-study: Guideline Adherence Leads to Overtreatment of Gallbladder Polyps
Wietsma, M.F.T. (2023) The POLYP-study: Guideline Adherence Leads to Overtreatment of Gallbladder Polyps.
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| Full Text Status: | Access to this publication is restricted |
| Embargo date: | 31 December 2024 |
| Abstract: | Gallbladder (GB) polyps are common but risk of malignancy remains low. Management guidelines rely primarily on polyp size as an indication for cholecystectomy. The surgical threshold with polyps >1 cm remains controversial and is proven to be insufficient. Guideline adherence remains sub-optimal according to the 2017 and 2021 guidelines; only 48.4% and 59.7% of patients reaching indication for cholecystectomy, underwent surgical treatment. Conservative adherence was even worse, with adequate follow-up duration after first visit in only 38.9% and 42.6% of patients following 2017 and 2021 guidelines. While guideline adherence remains sub-optimal, strict adherence to the guideline may paradoxically result in overtreatment and futile cholecystectomies. The aggressive management of small GB polyps leads to excessive costs and unnecessary follow-up imaging, whereas the malignant potential of these polyps remains very small. This study underscores the importance of refining pre-operative patient selection and identification of potentially neoplastic polyps |
| Item Type: | Essay (Master) |
| Faculty: | TNW: Science and Technology |
| Subject: | 44 medicine |
| Programme: | Health Sciences MSc (66851) |
| Link to this item: | https://purl.utwente.nl/essays/97838 |
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