Approach to gallbladder polyps in pediatric patients

Abstract

In pediatric patients, gallbladder polyps (GBPs) are lesions that are usually found incidentally on ultrasonography, which is the first-line modality for diagnosis. Though common in adults, GBPs are rare in children, and their prevalence remains unclear. Most GBPs in children are benign, and although the risk of malignancy is influenced by polyp size, growth rate, and morphology, specific criteria for the pediatric population are lacking. Management, therefore, is based on adult guidelines, with cholecystectomy being recommended only in symptomatic patients and for rapidly enlarging or 10-mm polyps and those with unfavorable morphology to avert the risk of malignant transformation, while surveillance is applied to asymptomatic patients with smaller polyps. Further research is needed to develop pediatric-specific guidelines for the management of GBPs. This review discusses the classification, diagnosis, risk factors, and management of pediatric GBPs.

Keywords: Gallbladder polyps; Gallbladder stones; Cholecystectomy; hyperplastic polyps; Abdominal pain

Core Tip: Gallbladder polyps (GBPs) in children are rare and are often detected incidentally, with most management strategies extrapolated from adult guidelines due to the lack of pediatric-specific recommendations. This review highlights the current understanding of classification of GBPs, risk factors, diagnostic imaging modalities, and management approaches in the pediatric population. It emphasizes the importance of individualized care based on symptomatology, polyp characteristics, and potential malignancy risk while also underscoring the need for future pediatric-focused research to guide evidence-based practice.