Management and Treatment of Adenomyomatosis of the Gallbladder

Surgical Considerations

• The surgical risk related to cholecystectomy is minimal, with a morbidity of 2-8%, and is most closely associated with surgical indication and underlying comorbidities, according to the Radiology guidelines 1
• The risk of bile duct injury during cholecystectomy is approximately 0.3-0.6%, as reported in the Radiology journal 1

Diagnostic Approach

• If differentiation between tumefactive sludge and adenomyomatosis is challenging, short-interval follow-up US within 1-2 months with optimized technique is recommended, as suggested by Radiology 1, 2, 3
• CEUS or MRI should be considered if uncertainty persists after follow-up US, according to Radiology 1, 3
• CT has inferior diagnostic accuracy compared to CEUS or MRI for characterizing gallbladder lesions, as reported in Radiology 1, 2

Follow-up Recommendations

• The Society of Radiologists in Ultrasound (SRU) consensus suggests that extended follow-up of gallbladder lesions is not productive, with a maximum of 3 years being sufficient to identify the vast majority of polyp-associated malignancies, as stated in Radiology 4