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Gallbladder Polyps

Dr Thng Yongxian

Hepatopancreatobiliary & General Surgeon
MBBS • MMed • MRCS (IRE) • FRCSED • FAMS

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What Are Gallbladder Polyps?

Gallbladder polyps are growths emerging from the lining of the gallbladder, a small pear-shaped organ located beneath the liver.

 

Polyps can vary in size and are often benign. A small percentage may have the potential to develop into gallbladder cancer, particularly those larger than 1 cm in diameter.

 

The management and treatment of gallbladder polyps depend significantly on their size, growth rate, and the presence of associated symptoms.

Types of Gallbladder Polyps

Gallbladder polyps are classified based on their composition and potential to become malignant.

Cholesterol Polyps

These are the most common type, comprising over half of all gallbladder polyps. They are formed primarily from cholesterol deposits in the gallbladder wall and are almost always benign.

Inflammatory Polyps

As a result of chronic inflammation of the gallbladder, these polyps are less common and are typically benign.

Neoplastic Polyps

Neoplastic polyps have the potential to develop into cancer, although the risk is relatively low.

Prevalence and Risk Factors

Several factors influence the likelihood of developing gallbladder polyps:

  • Age and Gender: Polyps are more commonly diagnosed in individuals over the age of 50, with a higher prevalence in men than in women.
  • Cholesterol Levels: High cholesterol levels increase the risk of developing cholesterol polyps, the most common type of gallbladder polyps.
  • Obesity: Being overweight or obese is a significant risk factor for gallbladder polyps, likely due to associated metabolic and cholesterol abnormalities.
  • Gallstones: The presence of gallstones is associated with an increased risk of polyps.
  • Liver Cirrhosis: Individuals with liver cirrhosis are at a higher risk of developing gallbladder polyps.

Symptoms

Gallbladder polyps are often asymptomatic and do not usually produce noticeable symptoms.

However, in some cases, individuals may experience symptoms similar to gallbladder disease, including:

Biliary colic

Sudden and intense pain in the upper right abdomen or the centre of the abdomen, which can last from a few minutes to several hours.

Jaundice

Yellowing of the skin and eyes, although this is more commonly associated with gallstones or other gallbladder diseases.

Nausea and vomiting

Especially after eating fatty foods.

Diagnosis

Ultrasound

An abdominal ultrasound is the standard diagnostic tool for identifying gallbladder polyps. It is non-invasive, widely available, and can detect polyps as small as 1 mm in diameter.

Endoscopic Ultrasound (EUS)

For further evaluation, an endoscopic ultrasound may be recommended. EUS provides a closer and more detailed view of the gallbladder and can better assess the characteristics of polyps.

Additional Tests

In some cases, additional blood tests or imaging tests such as a computed tomography (CT) scan or magnetic resonance imaging (MRI) may be conducted to rule out other conditions.

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Observation and Monitoring

Several factors influence the likelihood of developing gallbladder polyps:

Observation and Monitoring

  • Regular monitoring is advised for small, asymptomatic lesions.

    Monitoring frequency may begin with a follow-up ultrasound at 6 to 12 months after initial detection, followed by less frequent check-ups if no change is observed.

Surgical Interventions

  • Cholecystectomy: Recommended for larger polyps due to an increased risk of cancer. Polyps increasing in size will also require removal. This surgical removal of the gallbladder is typically performed using a laparoscopic method, which is minimally invasive and involves several small incisions.

    Surgery may also be an option for polyps showing significant growth, those that cause symptoms, or exhibit suspicious features on imaging tests.

Preventive Measures

Recommendations to prevent the formation of gallbladder polyps include:

  • Maintain a Healthy Weight: Obesity is a known risk factor for gallbladder polyps and gallstones. Achieving and maintaining a healthy weight through a balanced diet and regular exercise can help minimise this risk.
  • Balanced Diet: A diet high in fruits, vegetables, whole grains and low in saturated fats and cholesterol, can support gallbladder health.
  • Regular Health Check-ups: Regular medical check-ups can help identify risk factors such as high cholesterol levels, which can be managed through diet, exercise, or medication to prevent gallbladder polyps.

Dr Thng Yongxian

Senior Consultant

HEPATOPANCREATOBILIARY & GENERAL SURGEON

MBBS (SG) • MMed (Surg) • MRCS (Ire) • FRCSEd (Gen) • FAMS (Surg)

Dr Thng Yongxian is a dual fellowship-trained Hepatopancreatobiliary & General Surgeon who has performed over 6000 surgical procedures.

  • Bachelor of Medicine & Bachelor of Surgery
  • National University of Singapore
  • Membership of the Royal College of Surgeons, Ireland
  • Master of Medicine, General Surgery, Singapore
  • Fellow of the Royal College of Surgeons, Edinburgh
  • Fellow of the Academy of Medicine, Singapore

He pursued his subspecialty training in Hepatopancreatobiliary surgery first in the Department of Hepatopancreatobiliary Surgery, Singapore General Hospital. Following this, he completed a clinical fellowship in Minimally Invasive Hepatopancreatobiliary Surgery at Seoul National University Hospital in Bundang, South Korea.


Dr Thng set up and pioneered the Minimally invasive surgery program for his hospital in complex liver and pancreas cases. His surgeries were featured on live national television. His surgical videos have also been presented at international surgical conferences. He also pioneered the use of capsule colonoscopy for colorectal screening.


Dr Thng has served on various committees at hospital, cluster and ministry level. Dr Thng served as a member of the Ministry of Health (MOH) Laparoscopic cholecystectomy Clinician workgroup for value-driven care (VDC).

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