Gallbladder Polyps: Concerns, Risks, and Surgical Options

Gallbladder polyp

Hello Doctor: My mother had an abdominal ultrasound at the hospital a month ago, which revealed two polyps in her gallbladder, one measuring 0.2 cm and the other 0.6 cm.
After a month, she had another examination at a different hospital, and the polyps were found to have grown to 0.6 cm and 0.7 cm.
After learning this, my mother has several questions she would like to understand: 1.
Why are the results from the two hospitals different? Is there a margin of error, or are the polyps growing too quickly? 2.
The doctor suggested that if the polyps grow to over 1 cm, they should be removed due to the risk of malignancy (cancer).
The surgical method recommended is laparoscopic surgery.
After the removal, since one polyp will be gone, will this cause any other complications? 3.
Similarly, is laparoscopic surgery considered major surgery? My mother is concerned about the risks involved.
4.
What should be monitored post-surgery? There are quite a few questions, and these are things my mother didn’t have time to ask during her outpatient visit.
Thank you for addressing my mother's concerns.

Pang Pang, 20~29 year old female. Ask Date: 2008/12/28

Dr. Lin Minghui reply Gastroenterology and Hepatology

Hello,
1.
Polyps can sometimes be multiple, and different hospitals may yield varying results.
The imaging equipment itself may have discrepancies, and factors such as the size of small polyps, angles, or whether different polyps have truly grown can all contribute to these differences.

2.
The gallbladder primarily serves to store bile, which is secreted by liver cells.
There is only one gallbladder responsible for storing bile, aiding in the digestion and absorption of fatty foods.
After gallbladder removal, it is advisable to avoid greasy foods.
Generally, this does not affect the quality of life, but a small percentage of individuals may experience abdominal pain post-surgery, which can sometimes be related to pre-existing conditions such as gallstones, tumors, or postoperative complications like bile duct narrowing or sphincter dysfunction.
3.
If a polyp grows rapidly, exceeding 1 centimeter, there is concern for potential malignancy, and the doctor may recommend gallbladder removal.
Typically, laparoscopic surgery is performed for this procedure, resulting in smaller incisions and quicker recovery, but the suitability for anesthesia and surgery still needs to be evaluated.
Wishing you good health,
Dr.
Lin Ming-Hui, Taoyuan Hospital, Department of Health

Reply Date: 2008/12/28

More Info

Understanding gallbladder polyps is crucial for making informed decisions regarding treatment options and potential risks. Gallbladder polyps are growths that protrude from the lining of the gallbladder and can vary in size and type. Here’s a comprehensive overview addressing your mother’s concerns.

1. Discrepancies in Ultrasound Results: Variations in ultrasound findings between different hospitals can occur due to several factors. These include differences in the equipment used, the skill and experience of the sonographer, and the timing of the examinations. It is also possible that the polyps have grown, although a growth rate of 0.1 cm in one month is relatively rapid. Regular monitoring is essential, and if there is significant concern, a follow-up with a more definitive imaging study, such as an MRI or CT scan, may be warranted.

2. Surgical Recommendations: The guideline that polyps larger than 1 cm should be considered for removal is based on the increased risk of malignancy associated with larger polyps. The surgical procedure typically recommended is laparoscopic cholecystectomy, which is minimally invasive. While the gallbladder is removed, many individuals live without it without significant long-term issues. The gallbladder's primary function is to store bile, which aids in fat digestion. After its removal, bile flows directly from the liver to the small intestine, which can lead to changes in digestion, particularly in the processing of fatty foods. Some patients may experience diarrhea or changes in bowel habits post-surgery, but these symptoms often improve over time.

3. Surgical Risks: Laparoscopic cholecystectomy is generally considered a safe procedure with a low complication rate. However, like any surgery, it carries risks, including bleeding, infection, and injury to surrounding organs. The overall risk is low, especially in healthy individuals. Your mother’s age and overall health will be considered by the surgical team to assess her suitability for the procedure.

4. Postoperative Care: After surgery, patients are typically monitored for a short period in the hospital before being discharged. Recovery usually involves managing pain with prescribed medications and gradually resuming normal activities. It is important to follow dietary recommendations, particularly in the initial weeks post-surgery. Patients are often advised to start with a low-fat diet and gradually reintroduce other foods as tolerated. Keeping an eye on any unusual symptoms, such as severe abdominal pain, fever, or jaundice, is crucial, as these could indicate complications.

In conclusion, while gallbladder polyps can be concerning, the majority are benign. Regular monitoring and following medical advice regarding surgical intervention are essential. It is advisable for your mother to have a detailed discussion with her healthcare provider about the risks and benefits of surgery, as well as any specific concerns she may have regarding her health and the procedure. This will help ensure that she feels comfortable and informed about her treatment options.

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