There are no symptoms and rarely abdominal pain… Surgery is required when the size is over 10mm.
Exercise instead of high-fat, high-calorie diets… Regular checkups are important.
As abdominal ultrasound examinations have become more common in recent health checkups, the frequency of gallbladder polyps being discovered has increased to approximately 2-9% of the entire population.
The gallbladder is an organ that stores bile produced by the liver. Located just below the liver, polyps that develop here are called gallstones. They are any type of protrusion of mucous membrane that protrudes internally from the gallbladder wall, excluding gallstones.
Gallbladder polyps are broadly divided into non-neoplastic and neoplastic polyps. Non-neoplastic polyps include cholesterol polyps, inflammatory polyps, and adenomyomatosis, while neoplastic polyps include adenomas and cancers. The majority (98%) of gallbladder polyps are non-neoplastic, with more than half being cholesterol polyps. Asymptomatic polyps measuring 10 mm or less in size typically require observation and periodic imaging follow-up without active treatment, such as surgery.
On the other hand, approximately 3-8% of gallbladder polyps are reported to be malignant. Gallbladder cancer, in particular, has a very poor treatment prognosis, with a five-year survival rate of only 5%. Furthermore, metastasis to surrounding organs is frequent and recurrence rates are high, making a complete cure difficult if treatment is delayed. However, if detected early, a complete cure can be expected with cholecystectomy.
The presence of gallbladder polyps can be relatively easily confirmed with an abdominal ultrasound, but no test can definitively distinguish between benign and malignant polyps until a biopsy is performed after surgery. The gallbladder wall is only about 2 mm thick, and digestive enzymes are present within. Even a small hole can allow these enzymes to enter the abdominal cavity, potentially causing new peritonitis and potentially threatening life. Therefore, biopsy is not performed. Therefore, prior to surgery, malignancy can only be determined using imaging methods.
Professor Choi Jeong-wan of the Department of Gastroenterology at Korea University Ansan Hospital said, “Usually, if the size of the polyp is 5mm or larger and it is not clear whether it is a cholesterol polyp or a tumorous polyp, a detailed examination is necessary.” He added, “Endoscopic ultrasound or abdominal ultrasound are superior to abdominal ultrasound in differentiating gallbladder polyps. CT/MRI “Additionally, by analyzing the exact size, number, shape, presence of blood vessels, and layered structure of the gallbladder wall of the polyp, the diagnosis rate of malignant polyp can be increased,” he said.
Treatment for gallbladder polyps varies depending on the patient's age, symptoms, and the presence of risk factors for gallbladder polyps. The primary treatment strategy is to screen for cases with a high risk of malignancy and perform early surgery.
Gallbladder polyps generally have few symptoms, but in rare cases, they may cause symptoms such as abdominal pain. If symptomatic, cholecystectomy may be considered regardless of the polyp's size. Even in asymptomatic cases, if the polyp is 10 mm or larger, surgery may be considered based on various test findings.
Even if the gallbladder is removed, there is no significant change in digestive function because the bile produced in the liver is supplied to the duodenum through the bile duct. However, symptoms such as indigestion, fatigue, and diarrhea may appear after the surgery, but most of them are temporary and gradually improve.
To prevent gallbladder polyps, avoiding high-fat or high-calorie foods and eating a balanced diet can be helpful. Maintaining a healthy weight through appropriate exercise is also recommended. Above all, regular checkups are crucial for early detection of malignant gallbladder polyps.
Professor Choi emphasized, “Most polyps that are less than 10mm in size and have no symptoms are benign and do not show significant changes in five-year follow-up observations, but some can develop into malignant tumors, so regular checkups are essential.” He added, “In some cases, it is important to accurately differentiate the tumor through a detailed examination, including endoscopic ultrasound, at a medical institution with sufficient experience and the ability to utilize various equipment.”