Gall Bladder Polyps

Dr. Robert Drake

The gallbladder is a small sac like organ 3 inches long and an inch wide located under the liver. Its function is to store bile that is made by the liver and used to help digest food.

Gallbladder polyps are growths that protrude from the lining of the gallbladder. They are usually found on ultrasound. Polyps can be cancerous but they rarely are. About 95% of gallbladder polyps are benign.

Symptoms of gallbladder polyps are similar to those of gall stones. They may include pain in the right upper quadrant, nausea, and vomiting.

Most polyps are composed of cholesterol build up. When it comes to polyps in the gallbladder size matters. The larger the polyp the greater the risk of cancer. The size of the gallbladder polyp can predict whether its cancerous (malignant) or noncancerous (benign). Small polyps that are less than 1 centimeter or about 1/2 inch are unlikely to be cancerous and do not require treatment. For smaller polyps follow up ultrasounds may be done to look for changes in size.

Gallbladder polyps larger than 1 cm are more likely to be cancerous or turn to cancer over time. Those greater than 2 cm may pose a significant risk of being malignant. A CT scan or PET scan may be used to evaluate larger polyps. If greater than 1.5 cm, 46-70% have a chance of being cancerous. Treatment of larger polyps includes surgical removal of the gallbladder.

Risk factors for gallbladder cancer include:

* Porcelain gallbladder when the gallbladder looks white like porcelain because its walls are calcified. This can occur after chronic gallbladder inflammation.

* Gallbladder polyps only 5 percent are cancerous.

* Women are four times more likely than men to get gallbladder cancer.

* Age over 65 with average age of 72.

* Latin and Native Americans and Mexicans have the highest risk.

* Family history of gallbladder cancer.

* Patients with chronic inflammation of the bile ducts.

Thoughtful balance of the risk of surgery against potential gallbladder cancer is done. Attention is paid to the overall cancer risk and consideration of careful monitoring.

Dr. Drake is board certified by the American Board of Family Medicine and is a past-president of the Kentucky Academy of Family Physicians and a member of the American Academy of Family Physicians. He has practiced in Somerset since 1984.

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