Gallbladder Polyps

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Published: January 26, 2017
Last reviewed: June 15, 2017

What is a gallbladder polyp?

Gallbladder polyp is an abnormal growth that protrudes from the inner surface of the gallbladder into its lumen.

The polyps greater than 5 mm can be detected by ultrasound.

In about 5% of the cases, the polyps become cancerous [1].

Gallbladder polyps bigger than 15 mm are at increased risk to develop into cancer, so they are usually removed.

 

Types of Gallbladder Polyps

Gallbladder polyps can be benign or malign [1]:

  • Benign polyps:
    • Pseudotumors:
      • Cholesterol polyps (most common, usually <10 mm, commonly multiple, with a stalk, do not develop into cancer)
      • Inflammatory polyps (<10 mm, do not develop into cancer)
    • Epithelial tumors: adenomas (5-20 mm, usually solitary and accompanied with gallstones, can develop into cancer)
    • Adenomyomatosis – a benign noninflammatory lesion that can develop into cancer
    • Mesenchymatous tumors: fibroma, lipoma, and hemangioma, leiomyoma, granular cell tumor
  • Malign polyps:
    • Adenocarcinoma
    • Mucinous cystadenoma
    • Squamous cell carcinoma
    • Adenoacanthoma

Risk Factors For Polyps

  • Age >60
  • Female sex
  • Gallstones
  • Primary sclerosing cholangitis
  • Chronic hepatitis B
  • Congenital Peutz-Jeghers and Gardner syndrome
  • Reference: [1]

Symptoms

In most cases, gallbladder polyps do not cause any symptoms, but sometimes they can cause:

  • Pain in the right upper abdominal quadrant
  • Nausea, vomiting

Polyps are often associated with gallstones [1].

Rare complications include acute acalculous cholecystitis, obstructive jaundice and cancer. Cholesterol polyps can detach, lodge in the common bile duct and cause pancreatitis [1].

Diagnosis

Gallbladder polyps greater than 5 mm can be detected by an ultrasound of the abdomen. An ultrasound can reveal the number and size of the polyps and distinguish between a cholesterol polyp and adenoma but cannot reliably distinguish between a benign and malign polyp (Picture 1[1].

Gallbladder polyp sonogram

Picture 1. An ultrasound image (sonogram) of a 2 cm gallbladder polyp
(source: Ultrasoundcases, by permission)

Endoscopic ultrasound (EUS) (Picture 2) and high-resolution ultrasound (HRUS) seem to be equally effective in differentiating between benign and malign polyps [1].

Gallbladder adenoma and polyp

Picture 2.  Contrast-enhanced endoscopic ultrasonography (EUS) of gallbladder adenoma – a benign tumor (A) and cholesterol polyp (B) 
(source: Science Central)

Computed tomography (CT), magnetic resonance imaging (MRI) and intravenous cholecystography are less sensitive in detective gallbladder polyps than an ultrasound [1].

Risk Factors For Development Into Cancer

  • Age >50
  • Diabetes mellitus
  • Gallstones or biliary sludge
  • Primary sclerosing cholangitis
  • Chronic infection with Salmonella typhi
  • Porcelain gallbladder (calcification of the gallbladder wall)
  • Polyp size >1.5 cm
  • Single polyp
  • Sessile polyp (without a stalk)
  • Symptomatic polyp
  • References: [1,2]

Treatment

A doctor will likely suggest gallbladder removal (cholecystectomy) when [1]:

  • Cholesterol polyps and other polyps with low cancerous potential are greater than 10 mm
  • Adenomas and other polyps greater than 6 mm are associated with increased risk of cancer
  • Polyps of any size are associated with primary sclerosing cholangitis

A surgical technique of choice for the removal of the gallbladder with polyps is laparoscopic cholecystectomy [1]. In polyps larger than 18 mm, which are commonly cancerous, an open surgery with gallbladder, partial liver and regional lymph node removal is indicated [1].

Gallbladder polyps

Picture 3. Multiple cholesterol gallbladder polyps in a removed and opened gallbladder (source: Wikimedia, CC license)

Follow-Up

Small polyps that are not removed should be followed up at regular intervals, for example, every 6 to 12 months [1].

Diet

There is no specific diet that would prevent gallbladder polyps. Since gallbladder polyps are commonly associated with gallstones, the diet that can help prevent gallstones may also reduce the risk of gallbladder polyps [3,4]. Main points:

  • Maintain healthy body weight.
  • Do not skip meals.
  • If you intend to lose weight, do it slowly.
  • Consume less saturated fats (red meat, cheese) and cholesterol (eggs, shrimps, organ meats).

24 Responses to Gallbladder Polyps

  1. patel ravi m says:

    in ctmri
    gallbladder appear distended and shows few hyper dense non-enhancing polyps attached to gallbladder wall largest polyps measure approx 6×6 mm along inferior wall of gallbladder
    no definite evidence of adjacent gallbladder wall thickening or peri-gallbladder free fluid.
    some slightly pain in Upperback side and abdomen.please give advice and allopathic or ayurvedic medicine.please reply

  2. Khawar says:

    Yesterday with ABDOMEN Ultrasound a non mobile echogenic focus without posterior acoustic shadowing measuring 2.1 mm in size was seen adherent to the posterior wall of my gallbladder, what does it mean, how should I proceed with the treatment of this. What could be the best treatment??? Should I further repeat some other lab test to further investigate……I am worried…please guide me in detail.

    • Jan Modric says:

      This sounds like a small gallbladder polyp, which usually, at this size, is not dangerous and is very unlikely cancerous. I’m not aware of any treatment for this. To remove such polyp, a doctor would need to remove the entire gallbladder.

  3. Kit howell says:

    Does apple juice can help curing gallblader polyps???

  4. Kit howell says:

    I get ultrasound last week and the result said i have gallblader polyps..how can i cure this one

  5. I had an altar sound done. I have a polyp just a little over a cm. 1.1. The doctor doesn’t seem to be concerned. I get a lot of pain in that area. Tenderness in stomach and feel nauseous at time. Don’t feel like eating at times. And can sleep at night. Should I be worried.

    • Sorry that was ment to say can’t sleep. Due to I worry about it. I can feel something there in my side all the time. I feel I’m emotionally tired and drain from it. I can’t get in to see a specialist til 3 months

      • Jan Modric says:

        I strongly recommend you to insist in having further investigations as soon as possible and NOT waiting for 3 months. Nausea, loss of appetite and tenderness in the gallbladder area are not normal.

  6. sohan says:

    i received ultra sound report for my gall bladder. they said the below thing:
    ” A 5 mm polyp versus sludge ball is seen within the gallbladder lumen. There is no evidence for calcified stone or cholecystitis.”

    What should i understand what type of polyp is it?

    • Jan Modric says:

      To me, it sounds that the doctor thinks it is either a fleshy polyp or a clump of dense bile (sludge ball). A sludge ball may (or may not) develop into a gallstone.

      • sohan says:

        Thanks Jan. Question: what do you mean my fleshy polyp? is it consider under adenomyometosis?

        • Jan Modric says:

          By a fleshy polyp I mean an overgrowth in the gallbladder wall that projects into the lumen…as opposed to a sludge ball, which develops from the bile and subsequently get attached to the wall and looks like a polyp. It is a pathologist who can say which exact type of the polyp it is – after gallbladder removal.

  7. Mouse says:

    My close friend diagnosed with 5 mm polyp and does not have any gallstones. Is it true that if you have single polyp -it means is more chance to be having cancerous?

    • Jan Modric says:

      I wouldn’t know that…The risk of cancer increases with the polyp size. Polyps under 10 mm are not likely cancerous.

  8. Sunny says:

    I had small gb polyp 4mm in the neck of gb but I don’t have any pain yet what should I do surgery is necessary or it dissolve by medicine.I consult with doctor he said to me keep medicine for 3 months and avoid fried food.what should I do now

  9. Angela says:

    I had small Gb polyp 4mm, cause of that i feel sharp pain in my upper Abdomen ,back & on My side ,what should i do to reduce the pain and is surgery is necessary or it dissolve by any medicine.

    • Jan Modric says:

      Small polyps unlikely cause pain or any other problems. You may want to ask a doctor if you have gallstones. There are several non-gallbladder related causes of right upper abdominal pain, one of them is trapped gas, for example.

  10. Siddharth Tamang says:

    I had a growth of 4.7 mm polyp is it harmful
    .

    • Jan Modric says:

      Polyps tend to grow and a doctor can say at which point the gallbladder needs to be removed. 4.7 mm by itself is not considered dangerous but a doctor can tell.

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