Progression Of Gallbladder Polyps
In the 2013 follow-up study, we examined 27 subjects who had already had gallbladder polyps in 2002. Fourteen of these subjects still had polyps, while 13 subjects no longer had any evidence of gallbladder polyps on ultrasound scanning. In addition, 36 subjects who did not have polyps in 2002 had developed them by 2013.
The natural progression of gallbladder polyps could be observed in the 14 patients who had polyps in the original study in 2002 and also participated in 2013 . The number of polyps increased in six subjects , decreased in a further six subjects , and was unchanged in the remaining two . Polyp size decreased in seven subjects , increased in five subjects , and stayed the same in the other two .
How Are Gallbladder Polyps Diagnosed
Gallbladder polyps are often discovered accidentally on a radiology exam, such as a transabdominal ultrasound. If youre seeking care for gallbladder symptoms, youll probably have an ultrasound first. Healthcare providers can identify gallbladder polyps this way, but they might not be able to tell what kind they are. They might want to follow up with a more detailed imaging test, such as a CT scan or an endoscopic ultrasound, to get a better look.
Gallbladder Polyps Cancer Symptoms
Some patients with gallbladder cancer may experience a lack of symptoms, or they may be challenging to spot. However, there are a few gallbladder polyps cancer symptoms, including:
- A lump in the stomach
- Having a high temperature or feeling shivery or hot
- The skin or the whites of the eyes becomes yellow , feces may become paler, urine can become darker, and itchy skin
- Experiencing a loss of appetite or losing a significant amount of weight without doing it on purpose
Some patients may also experience gallbladder polyps and cancer symptoms such as:
- Being sick or feeling ill
- Sharp pain in the stomach
- Experiencing a dragging feeling in the right side of the stomach
- A swollen stomach
However, some patients with medical conditions such as irritable bowel syndrome may get similar symptoms regularly. It is vital to consult with a healthcare professional to determine the exact cause of your symptoms. By doing this, you will get diagnosed early, and your chances of recovery will be significantly boosted.
Sometimes, patients with gallbladder polyps and cancer symptoms that are undiagnosed may become used to these signs. However, if you have any doubts or concerns, make sure to consult with your doctor immediately.
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Prevalence Of Gallbladder Polyps
The prevalence of gallbladder polyps was 6.1% in the original 2002 study: 6.2% for women and 6.0% for men. There was a trend towards an increasing prevalence of polyps with age, although the rate was already somewhat elevated in the group aged 3140 .
Fig. 2
Relative frequency of gallbladder polyps according to age in the original EMIL study in 2002 and the follow-up study in 2013
In the 2013 follow-up study, the prevalence was 12.1% with women and men being affected in relatively equal proportions . The highest prevalence was seen in the 3140 age group, but there was also an upwards trend with increasing age in the older age groups . The mean age of the cohort was 57.8±11.7years. The youngest person was 31years of age and the oldest 74. There were 23 subjects in the 3140 age group and 124 in the over-65s. Most of the patients were aged 5165years. The mean BMI was 29.2±4.3, ranging from 20.7 to 41.1 .
Treatments For Gallbladder Polyps
If your gallbladder polyp is smaller than a half-inch wide, your doctor may just want to wait and see if it changes. They might schedule regular ultrasounds to see if the polyps grow. This is a common situation if you dont have any symptoms.
Other treatments for gallbladder polyps include having surgery to remove your gallbladder. This is also a potential if your gallbladder polyp is larger than a half-inch wide. Regardless of whether you have surgery or not, it helps to improve your diet. This can help you avoid fatty or high-cholesterol foods. You can also start eating more fruits and vegetables.
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Enhancing Healthcare Team Outcomes
Most true gallbladder polyps are not malignant. Often times they are not even true polyps and don’t need surgical intervention. A thorough understanding of the genesis and course of gallbladder polyps needs to held by the primary care physician and surgeon. Even though they may not exhibit any sign of malignancy or premalignancy, they must be followed. Yearly ultrasounds are noninvasive and will alert the following physician to enlargement, which would suggest the need for cholecystectomy. Delay in identifying such activity could jeopardize the patient and possibly lead to a missed newly developed cancer. If caught early, these neoplasms are curable. If caught late, then the prognosis is much more dismal.
Listing Of Usual Initial Therapeutic Options Including Guidelines For Use Along With Expected Result Of Therapy
Cholecystectomy is recommended for polyps larger than 10 mm in size or polyps that are present in a patient with gallstones, PSC, or those patients who are symptomatic.
For patients who are high risk for surgical intervention and have polyps larger than 10 mm, periodic surveillance every 6 to 12 months with transabdominal or endoscopic ultrasound is acceptable, with the caveat that these patients may need referral for surgery if there is any change in the character of the polyp.
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How Can I Be Sure That The Patient Has Gallbladder Polyps
Gallbladder polyps typically do not cause any symptoms. They are usually found incidentally after cholecystectomy or on imaging studies performed for other causes. Occasionally, when seen on imaging performed for abdominal pain, the symptoms may be similar to biliary pain.
Detached portion of the polyp may block the Hartmanns pouch or cystic duct and may cause cholecystitis. Similarly, if the detached portion of the polyp blocks the main bile duct, this may result in obstructive jaundice or pancreatitis.
Gallbladder polyps have also been associated with chronic dyspeptic abdominal pain.
Usual constellation of clinical features
Gallbladder polyps can have various clinical features. The asymptomatic patient is the most common. Other presentations include biliary pain , dyspepsia, obstructive jaundice , cholangitis , and pancreatitis .
What Is The Treatment For Gallbladder Polyps
Patients who have no symptoms of gallbladder polyps usually do not require treatment. Doctors generally suggest regular monitoring with ultrasound to see if the polyp gets bigger.
Treatment for patients who are symptomatic involves surgical removal of the gallbladder for:
- Polyps larger than 1 cm
- Patients with gallstones
- Patients with a high risk of developing cancer
- The size of the gallbladder polyp can often indicate whether it is cancerous
- Polyps that measure less than a half inch in diameter are usually benign
- Polyps larger than a half inch in diameter have a higher risk of becoming malignant
- Polyps larger than three-fourths of an inch have a high probability of being malignant
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How Can You Tell The Difference Between Gallbladder And Liver Pain
When you feel pain in your abdomen, it can be hard to figure out whats causing it. Liver pain can take many forms. Depending on the cause, you may feel pain in your upper right abdomen, mid-abdomen, shoulders or back.
But your liver doesnt have any pain receptors. So if you feel pain in your liver area, its likely due to damage or inflammation of the surrounding tissues. If you are experiencing any severe pain, its best to check in with your healthcare provider to determine the cause.
A note from Cleveland Clinic
If youre experiencing severe pain in your upper right abdomen, you may have an issue with your gallbladder. One of the main causes of gallbladder pain is gallstones. Your healthcare provider may recommend surgery to remove your gallbladder if you consistently have gallbladder attacks. While this may sound scary, your body doesnt need your gallbladder to function. Youll feel much better once you have it removed.
Last reviewed by a Cleveland Clinic medical professional on 06/28/2022.
References
How Do I Know If I Have One
A small gallbladder polyp is usually discovered during an ultrasound scan of your abdomen . A doctor may then take a tissue sample from the tiny mass so it can be analyzed under the microscope. This procedure is called an endoscopic ultrasound-guided biopsy, and its done using an endoscopea long thin tube with a light at one end and a camera at the other.
This tube will be inserted into your throat, down through your oesophagus, and into your stomach, where tissue will be removed before the organ is completely removed from its position in order to check for cancer cells.
Its more common for people to not need surgery and instead receive treatment for their symptoms or complications, such as bleeding issues caused by blood clots forming inside their bodies after lying on one side for too long while sleeping, which may cause them not waking up properly after being asleep all night long due to having felt tired earlier still feeling tired even though we had slept enough hours during our sleeping time yet still being sleepy during daytime hours when we should have been awake already feeling alert instead.
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What Causes Gallbladder Polyps
It isnât clear what causes gallbladder polyps. Your gallbladder is a pear-sized organ located beneath your liver. It stores and concentrates bile from your liver.â
Your body uses bile to break down and absorb fat. Your gallbladder releases it into the first section of your small intestine. Bile contains bile salts, cholesterol, fat, and bile pigments.
There may be a connection between gallbladder polyps and the way your body breaks down fat. You may be more likely to get gallbladder polyps if your body doesn’t break down fat well.
Incidence Of Gallbladder Polyps
The prevalence of gallbladder polyps was reported as 4.36.9%. Polypoid gallbladder lesions include a variety of pathologic types. Although there are some differences according to reports, the prevalence of polypoid lesions of the gall bladder are reported in 212% of cholecystectomy specimens, probably dependent on indications for cholecystectomy.
Age and gender seem to be notable factors for incidence of gallbladder polyps. In a study of 1558 patients with gallbladder polyps, the age at the time of diagnosis was 49 years. In the majority of publications in which the ratio is calculated, the incidence is more prevalent in men. The sex ratio and age at the time of diagnosis of gallbladder polyps was 1.15 to 1 .
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Causes Of Gallbladder Polyps
Unlike gallstones, there isn’t a lot of research and understanding about what causes gallbladder polyps. Doctors think there’s a connection to the way your body processes fat. Bile helps your body break down and digest the fat you eat. If your gallbladder doesn’t help break down the fat well, you might be more likely to get polyps.
How Are Gallbladder Polyps Treated
Observation: Most polyps wont cause any problems or require any treatment, but your healthcare provider will want to keep them under observation to make sure they arent growing too big or too fast or producing any new symptoms. Theyll do this with periodic ultrasound tests. If they see any troubling trends, they will recommend gallbladder removal.
Surgery: While it might seem severe, gallbladder removal is the only known treatment for gallbladder diseases. If your polyps come with inflammation or with gallstones, your healthcare provider will recommend removal to prevent further complications. Theyll also recommend it for any chance of possible cancer. You can live well without your gallbladder.
There are two kinds of gallbladder removal surgery.
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Risk Factors For Polyps
Polyps of gall bladder are tumor-like lesions of this organ. Little has been known about factors associated with the occurrence of gallbladder polyps. The formation of gallbladder polyps is however associated with fat metabolism. Relationship between gallbladder polyps and family history of some diseases suggests to perform some genetic studies.
In contrast to the well-known risk factors for gallstones, attempts to identify risk factors for developing gallbladder polyps have not shown any consistent relationship between formation of polyps and age, gender, obesity, or medical conditions such as diabetes. There is some literature to suggest an inverse relationship between gallbladder polyps and stones. It is hypothesized that polyps either mechanically disrupt the formation of stones or that polyps are harder to diagnose radiographically when stones are present.
Patients with congenital polyposis syndromes such as Peutz-Jeghers and Gardner syndrome can also develop gallbladder polyps. A large retrospective analysis of risk factors for gallbladder polyps in the Chinese population identified chronic hepatitis B as a risk factor.
Proposed patient risk factors for malignant gallbladder polyps include age greater than 60, presence of gallstones, and primary sclerosing cholangitis. Polyp risk characteristics include a size greater than 6 mm, solitary, and sessile.
What Are Gallbladder Polyps
Gallbladder polyps are abnormal growths of tissue that protrude out of the inside mucous lining of your gallbladder. There are a few different kinds, made up of different materials. They are mostly harmless, but they can be a sign of another gallbladder condition. Rarely, they may cause complications such as inflammation, and about 5% of them may become cancerous.
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Where Is Gallbladder Pain Felt
The location of gallbladder pain can vary. Your gallbladder is located in your upper right abdomen, so you will most often feel pain in this area. You may also feel upper mid-abdominal pain or chest pain.
You may feel gallbladder referred pain. Referred pain means the pain you feel in one part of your body is caused by pain in another part of your body. Gallbladder pain may spread to your back and right shoulder.
What Other Diseases Conditions Or Complications Should I Look For In Patients With Gallbladder Polyps
Most gallbladder polyps are benign. However, there is a risk of neoplastic progression, especially in larger polyps or polyps with uncertain character. The incidence of carcinoma has been said to be as high as 100% in polyps larger than 2 cm.
Gallbladder polyps may detach and block the Hartmanns pouch , cystic duct , main bile duct, or ampulla . Neoplastic progression to carcinoma is commonly seen with larger polyps, especially those more than 10 mm.
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Laparoscopic Cholecystectomy For Gallbladder Polyp Is Significant In The Prevention Of Gallbladder Cancer
Hun Ryong, Gum-Chol Jang, Dae-Mo Ryu, Chung-Sa Ji
Abdominal Surgery Department Pyongyang Medical College of Kim Il Sung University , , Democratic Peoples Republic of Korea
Contributions: Conception and design: GC Jang Administrative support: CS Ji Provision of study materials or patients: DM Ryu Collection and assembly of data: H Ryong Data analysis and interpretation: GC Jang Manuscript writing: All authors Final approval of manuscript: All authors.
Correspondence to:
Background: Aim is to evaluate the significance of laparoscopic cholecystectomy for gallbladder polyp by analyzing the accidental incidence of gallbladder cancer diagnosed following surgery for gallbladder polyp and occurrence rate of postcholecystectomy syndrome.
Methods: We analyzed several clinical factors and pathohistological findings, and occurrence rate of postcholecystectomy syndrome among patients undergoing the laparoscopic cholecystectomy for gallbladder polyp.
The risk factors of gallbladder polyp malignancy were the size of the gallbladder polyp and the age of the patients. We couldnt exclude the malignancy risk of gallbladder polyp though the size was small and all gallbladder polyp needs to be resected laparoscopically.
Keywords: Gallbladder polyp gallbladder cancer laparoscopic cholecystectomy postcholecystectomy syndrome
Received: 04 September 2019 Accepted: 28 September 2019 Published: 20 November 2019.
doi: 10.21037/dmr.2019.10.01
A Tabular Or Chart Listing Of Features And Signs And Symptoms
There are no pathognomonic features of gallbladder polyps. Rather, most of them are found incidentally after a cholecystectomy or on imaging performed for some other indication.
Less common clinical presentations are biliary pain when polyps prolapse into the Hartmanns pouch, with decrease in intensity of pain after spontaneous reduction. Occasionally, patients may present with cholecystitis if the detached portion of the polyp blocks the cystic duct.
Most commonly, patients have nonspecific dyspeptic symptoms. Other presentations as mentioned above could be related to the polyp blocking the main bile duct, resulting in jaundice or pancreatitis.
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Can Gallbladder Pain Last For Weeks
No. Gallbladder pain may last for a few minutes to a few hours. If it doesnt go away within a few hours, you may have a serious health condition. You should see your healthcare provider for pain lasting longer than two to three hours, especially if you have other symptoms. Gallbladder pain can be so severe that people normally go to the emergency room.
What Causes Gallbladder Pain
The most common cause of gallbladder pain is gallstones. Gallstones, or cholelithiasis, are stone-like objects that can develop in your gallbladder. Theyre made of hardened materials in your body. Most gallstones are made of cholesterol. Gallstones range in size. They can be as small as a grain of salt to as big as a golf ball. Many people with gallstones may not know they have them and may not need treatment.
Other causes of gallbladder pain include:
Bile duct stones
Gallstones can also travel from your gallbladder to your common bile duct, which is your largest bile duct. Common bile duct stones are less common and more serious than gallbladder stones. When a stone makes its way out of your gallbladder, it can block your common bile duct. This can result in serious medical conditions such as pancreatitis.
Gallbladder inflammation
Gallstones can cause cholecystitis, which is the inflammation of your gallbladder. This can occur when a gallstone blocks the flow of bile out of your gallbladder. When bile gets trapped in your gallbladder, bacteria can collect and an infection can develop.
Gallbladder disease
Gallbladder polyps
Gallbladder polyps are abnormal growths of tissue inside the lining of your gallbladder. These polyps are mostly harmless, but they can signal another gallbladder condition. They can cause complications such as inflammation. About 5% of gallbladder polyps can cause cancer.
Gallbladder cancer
Bile duct cancer
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