Gallbladder Polyps: Concerns and Treatment Options - Gastroenterology and Hepatology

About gallbladder polyps?

Dear Doctor,
I apologize for not including the website in my previous email and am resending it in hopes of receiving your response.
In 2005, during a health check at a medical center, I was informed that I had gallbladder polyps.
The doctor at that time did not say much and only recommended regular follow-ups.
Out of fear, I sought a second opinion at another medical center's hepatobiliary and gastroenterology department, where they told me that my gallbladder was normal and no polyps were found.
Therefore, I did not pursue follow-up examinations for many years.
In 2010, my company conducted employee health checks, and the hospital arranged for an abdominal ultrasound, which also showed no polyps.
However, in 2011, during another health check at the same hospital, I was told that there were polyps in my gallbladder, but they did not specify how many.
When I asked the doctor about the size of the polyps, they mentioned it was 0.45 cm.
This health check report did not indicate the need for further examinations.
(My total cholesterol is 150, which is normal.)
I would like to ask you:
1.
Do I have gallbladder polyps or not? Why have the results varied across multiple examinations?
2.
Given that six years have passed from 2005 to 2011 and the polyps do not seem to have significantly increased in size, should I be less concerned?
3.
Do I need treatment? If treatment is necessary, is it mandatory to remove the entire gallbladder? Can it be done laparoscopically, or is traditional surgery required? I am genuinely worried and appreciate your time in addressing my concerns.
Thank you!

Sally, 40~49 year old female. Ask Date: 2012/03/16

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello Ms.
Sally,
1.
Gallbladder polyps smaller than 0.5 cm may not be visible due to angle and intestinal gas interference.

2.
Polyps that have not increased in size only require follow-up every 1-2 years.

3.
The definitive treatment for gallbladder polyps is still cholecystectomy.
The surgical approach will be determined after discussion with the surgeon.

Changhua Hospital is concerned about your health.

Dr.
Chen Shih-Tien

Reply Date: 2012/03/16

More Info

Gallbladder polyps are growths that occur on the inner lining of the gallbladder. They are often discovered incidentally during imaging studies, such as ultrasounds, and can vary in size and number. Your concerns regarding the diagnosis and management of gallbladder polyps are valid, especially given the discrepancies in the findings from different medical evaluations over the years. Let’s address your questions one by one.

1. Do I have gallbladder polyps? Why are there inconsistencies in the findings?
The presence of gallbladder polyps can sometimes be challenging to diagnose accurately. Variations in ultrasound techniques, the experience of the technician, and the equipment used can all contribute to differing results. It is also possible that small polyps may not be consistently detected, especially if they are less than 1 cm in size. The fact that you have received conflicting reports over the years suggests that the polyps may be small or that they may not be present at all. It is essential to have a follow-up with a healthcare provider who can assess the situation comprehensively, possibly considering additional imaging modalities like a CT scan or MRI if necessary.

2. Is it concerning that the polyp has not significantly increased in size over six years?
Generally, gallbladder polyps that are less than 1 cm in size are considered low-risk for malignancy, especially if they remain stable over time. The fact that your polyp has not shown significant growth is a reassuring sign. Most polyps of this size are benign and do not require immediate intervention. However, regular monitoring is advisable, as changes in size or new symptoms could warrant further evaluation.

3. Do I need treatment? Is gallbladder removal necessary?
Treatment for gallbladder polyps is typically guided by their size and the presence of symptoms. For polyps less than 1 cm, especially if asymptomatic, the standard approach is to monitor them with periodic ultrasounds. If a polyp grows larger than 1 cm or if you experience symptoms such as abdominal pain, nausea, or jaundice, surgical intervention may be considered.
If surgery is indicated, laparoscopic cholecystectomy (gallbladder removal via small incisions) is the preferred method due to its minimally invasive nature and quicker recovery time compared to traditional open surgery. Open surgery is usually reserved for more complicated cases or when laparoscopic techniques are not feasible.

In conclusion, while the presence of gallbladder polyps can be concerning, the management typically involves monitoring, especially for small, asymptomatic polyps. It is crucial to maintain regular follow-ups with your healthcare provider to ensure that any changes in your condition are promptly addressed. If you have further concerns or experience new symptoms, do not hesitate to seek medical advice. Your health and peace of mind are paramount, and a thorough discussion with your physician can help clarify your situation and guide you through the next steps.

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