Gallbladder Polyp: Are These Indications for Gallbladder Removal

What are Gallbladder polyps

Gallbladder polyps are gallbladder wall elevations that project into the lumen. Commonly detected on ultrasound done for other symptoms. Incidence vary from 0.3 to 9%
As the incidence of polyp is more and chances of malignancy is rare, selective surgery is done for these patients and should be counselled accordingly

Symptoms of Gallbladder polyps

As the gallbladder polyp are attached to gallbladder wall and are non-mobile these do not cause any symptoms. Large polyps because of there size and twisting effect or when change into cancer may cause pain

Diagnosis of Gallbladder polyps

Ultrasound abdomen is the most common investigation for diagnosis.It will detect the number and size of polyp. CECT abdomen is done when USG show suspicious of gallbladder cancer

Indication of Surgery

The only indication for surgery in gallbladder polyps is risk of cancer. It is said that risk of cancer is high in polyp size more than 10mm, single polyp and sessile polyp
For Polyp less than 6mm follow up ultrasound is done at 1, 3 and 5 year. For polyp 6-9 mm ultrasound is done at 6 months, 1,2,3,4 and 5 year; If during follow up increases by 2mm or more cholecystectomy is advised
For polyps 6-9mm if there are risk factors for gallbladder malignancy like age > 50 years, sessile polyp, indian ethinicity, PSC then also cholecystectomy is advised

Surgery for gallbladder polyp

Laparoscopic cholecystectomy is the standard surgical procedure for gallbladder polyp. Advantage of laparoscopy surgery being early recovery and discharge from the hospital. If investigations suggest cancer doubt in polyp then it should be treated like gallbladder cancer. Intra-op frozen section should be sent from suspicious area and should proceed accordingly


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