A New Risk Scoring System to Predict Malignancy in Gallbladder Polyps: a Single-Center Study

Ultrasonography (US) is the most commonly used radiological method in the diagnosis of gallbladder polyps (GBPs). Patients diagnosed with GBPs on US are operated on with risk factors that do not have a high level of evidence. Our aim in this study is to determine the sensitivity of US in diagnosis GBPs, to define risk factors for neoplastic (NP) polyps, and to develop the risk scoring system.

Between July 2011 and July 2021, 173 patients who were found to have GBPs in the pathology specimens after cholecystectomy were included in the study. Patients were divided into two groups: nonneoplastic and NP groups.

GBPs in patients who underwent abdominal US for any reason was 4.5%. The sensitivity of US in the diagnosis of GBPs was 56.6%. Comparison between groups, age ≥50, presence of symptoms, polyp size >12.5mm, single polyp, concomitant gallstones, and gallbladder wall thickness ≥4mm were statistically in the NP group. A risk scoring system was developed using these values. If the risk score was <4, 0.6% of GBPs was NP polyps. If the risk score was ≥4, 63.2% of GBPs were NP polyps.

Our risk scoring system can prevent unnecessary choelcystectomy. Because the incidence of NP polyps in low-risk patients (risk score <4) is extremely rare.