The task of the gallbladder is to store the bile produced by the liver. During digestion, the gallbladder contracts and empties its bile into the intestine.
What is a Polyp?
The epithelial cells lining the inner surface of the entire digestive system can grow where they are and form lumps of different diameters. These structures are generally called “polyps”. Although polyps are commonly seen in the large intestine (colon), nowadays, with the development of imaging techniques, the diagnosis of polyps in the gallbladder has begun to be made more frequently.
For detailed information: What is a Polyp? You can read our article.
What are the Characteristics of Gallbladder Polyps?
Gallbladder polyps; They start from the membrane layer formed in the epithelial cells covering the inner wall of the sac, and the polyp stem grows into the organ cavity. Its incidence in the general population is between 3% and 6%.
Polyps can exert pressure on the bile duct of the gallbladder depending on their size, and they can prevent the participation of bile, which is especially necessary for fat digestion, into digestion. Over time, they can cause inflammation in the gallbladder. However, especially small-sized gallbladder polyps usually remain silent without symptoms. While 95% of polyps are benign structures, the rest are at risk of becoming cancerous.
Polyp diameter determines the risk of cancer; Polyps 12 mm or less in diameter are considered benign. Polyps with a diameter of 1-2 cm should be closely monitored for the risk of cancer, while those with a diameter larger than 2 cm have a serious risk of cancerization and development of gallbladder cancer.
What are the Types of Gallbladder Polyps?
Polyps are structures that are diagnosed visually and grow into the cavity of the hollow organ in ultrasonography. Therefore, the content of the polyp cannot be understood by imaging. About 60% of polyps seen in the gallbladder are cholesterol-containing polyps. These polyps are benign and do not show cancerous properties. Other types of polyps are 25% adenomyomas, ie structures originating from the wall of the sac from both muscle and mucosa; 10% are inflammatory polyps and 4-5% are true (adenomatous) polyps.
25 % of adenomatous polyps have the potential to become cancerous.
What are the Risk Factors in Gallbladder Polyps?
The reason for the development of gallbladder polyps is not fully understood. Although a definite relationship could not be shown in clinical studies, it is suspected that around 40 years of age, female gender, diabetes and obesity may play a role in the development of polyps. In addition, fat metabolism and familial genetic factors are believed to contribute to polyp development.
What are the Symptoms of Gallbladder Polyps?
Gallbladder polyps may not always show signs and symptoms. In cases where they give symptoms, the patient may have
- discomfort in the right upper quadrant of the abdomen,
- bloating,
- nausea and complaints that increase with food (loss of tolerance).
How to Diagnose Gallbladder Polyps?
Most gallbladder polyps are detected by chance while investigating any disease. Non-invasive imaging methods (abdominal ultrasonography, computed tomography (CT), magnetic resonance imaging (MRI)) or endoscopic ultrasonography, which is a minimally invasive radiological method, are used for diagnosis.
What is the Treatment for Gallbladder Polyps?
A recommended roadmap has been created for the diagnosis and treatment of gallbladder polyps. The most important parameter is the size of the polyp determined by ultrasonography.
Gallbladder polyps with a size over 20 mm should be considered as cancer and operated as soon as possible. 10-20mm. They describe polyps between the two as 'cancer suspect'. The gallbladder must be surgically removed. About 90 percent of gallbladder polyps are under 1 cm. If there are signs of inflammation of the gallbladder such as swelling, pain, nausea, fever after meals, the gallbladder should be removed by surgery.
Polyps that are less than 5 mm in size and do not cause any complaints are checked with ultrasonography every 6 months. If no growth is observed, this check is repeated every year. When growth is seen or signs of inflammation occur, the decision for surgery is made. Otherwise, the follow-up can be continued.
5 mm. with 1 cm. In silent polyps, the first control ultrasonography should be done after 3 months, and the other controls should be done every 6 months. If there is no change in size after the third control, follow-up with annual ultrasonography is continued.
Gallbladder i When is Surgery Necessary for Polyps?
Surgical removal of the gallbladder is required in 3 cases:
- If there is a polyp of >1cm in diameter in the sac,
- <1 cm in the sac, but multiple if there is a polyp
- The polyp in the sac is <1cm, but if the patient has complaints.
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