Gallbladder Polyps

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.

What is the gallbladder?

The gallbladder is part of the digestive system. It’s a small, hollow organ that sits under your liver. It looks like a fig. The gallbladder receives bile from the liver and concentrates it (extracts water) while storing it. When fats enter the digestive system, the gallbladder is triggered to release the concentrated bile into the small intestine to help break down the fats.

How common are gallbladder polyps?

Studies suggest that 4% to 7% of adults may develop gallbladder polyps. But only 5% of these are the kind that could potentially turn into cancer. Between 60% and 90% are pseudopolyps — not true tumors or “growths,” but deposits of cholesterol that cling to the gallbladder wall. Another 5% to 10% are inflammatory polyps, a kind of scar tissue from chronic inflammation.

What are the different types of gallbladder polyps?

Pseudopolyps: Also called cholesterol polyps, these are the result of a benign condition called cholesterolosis. It means that you have extra cholesterol lipids that accumulate and stick to the gallbladder wall, forming polyps.

Inflammatory polyps: These are a type of scar tissue associated with chronic inflammation of the gallbladder wall (cholecystitis).

Adenomyomatosis: An abnormal overgrowth of the gallbladder lining that forms cysts in the gallbladder wall. Scientists aren’t sure why it occurs, but it isn’t harmful.

Adenomas: Benign tumors composed of cells that resemble the lining of the biliary tract, the channel that connects the gallbladder to other organs. They pose a .5% risk of becoming cancerous.

Malignant polyps: These are usually adenocarcinoma, the most common type of cancer that affects the internal organs.

Can gallbladder polyps cause pain?

Most polyps don’t cause pain or any symptoms at all. In rare circumstances, they might cause inflammation and pain if they block one of the ducts leading from the gallbladder. But there are other more likely causes of gallbladder inflammation and pain than polyps — particularly gallstones.

What symptoms do gallbladder polyps produce?

Gallbladder polyps commonly cause no symptoms. They’re usually discovered accidentally while healthcare providers are looking for something else. However, a small number may cause symptoms if they happen to obstruct one of the passageways that branch off from the gallbladder: the cystic duct or the bile duct.

Polyps that develop in the cystic duct may obstruct the flow of bile into the gallbladder, causing inflammation of the gallbladder wall (cholecystitis). Pieces that break off and travel into the bile duct may obstruct the flow of bile out of the gallbladder, causing inflammation of the bile duct (cholangitis) or the pancreas (pancreatitis).

Symptoms of inflammation may include:

• Abdominal pain.
• Fever.
• Nausea and vomiting.
• Jaundice.

More rarely, these symptoms may also indicate gallbladder cancer.

What causes gallbladder polyps?

True tumors are abnormal growths of cells. We don't know why they occur. Cholesterol polyps and inflammatory polyps, which aren’t true growths, are byproducts of other conditions. Cholesterol polyps are caused by cholesterolosis, and inflammatory polyps are caused by cholecystitis. These two types make up the majority of gallbladder polyps.

What risk factors are associated with gallbladder polyps?

You may be more likely to develop gallbladder polyps if you have:

• Gallstones.
• Cholecystitis.
• Cholangitis.
• Hepatitis B.
• Familial Adenomatous Polyposis (FAP).
• Peutz-Jeghers Syndrome.
• High cholesterol.
• You're over age 50.

How are gallbladder polyps diagnosed?

Gallbladder polyps are often discovered accidentally on a radiology exam, such as a transabdominal ultrasound. If you’re seeking care for gallbladder symptoms, you’ll 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.

How do I know if my gallbladder polyps are cancerous?

Unfortunately, healthcare providers can’t tell for sure if polyps are cancerous without removing them first. And they can't remove the polyps without removing the gallbladder entirely. While you can live well without your gallbladder, healthcare providers don’t want to remove it without good cause. So they try to calculate the likelihood of cancer based on your symptoms and risk factors.

Malignant polyps tend to be larger than benign ones — usually more than 2 centimeters in diameter. To be safe, healthcare providers typically recommend removing a polyp that is 1 centimeter or more. They’ll also recommend removal for symptoms of inflammation, such as pain and fever. They’ll continue to monitor your remaining polyps with annual ultrasounds.

How fast do polyps grow in the gallbladder?

A single polyp typically grows less than 2 millimeters in a year. A malignant polyp may grow faster. If your healthcare provider measures faster growth at your annual exam, they may recommend removing the polyp.

Benign polyps are more likely to appear in numbers, while malignant polyps tend to be single. If your polyps grow quickly in numbers, they probably aren’t malignant. But they might indicate another condition, such as chronic cholecystitis.

Can gallbladder polyps disappear on their own?

No. Some kinds of polyps do, but not gallbladder polyps. They are more likely to grow over time in both size and numbers. There is no way to remove them without surgery.

How are gallbladder polyps treated?

Observation: Most polyps won’t cause any problems or require any treatment, but your healthcare provider will want to keep them under observation to make sure they aren’t growing too big or too fast or producing any new symptoms. They’ll 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. They’ll also recommend it for any chance of possible cancer. You can live well without your gallbladder.

There are two kinds of gallbladder removal surgery.

• Laparoscopic cholecystectomy is a minimally invasive surgery that allows the surgeon to extract your gallbladder through a few small incisions. Instead of opening up your abdomen, the surgeon inserts a tiny lighted camera called a laparoscope through one small incision and uses it to locate the gallbladder on a screen. Then they remove the gallbladder through another small incision. Surgeons prefer to use the laparoscopic method when possible because it causes fewer complications and less recovery time (about two weeks).
• Open cholecystectomy might be required when cancer is highly suspected. That’s because the surgeon may have to remove other affected tissues and lymph nodes outside of the gallbladder. An open cholecystectomy requires one larger incision under the right ribcage to open up your abdomen. This is a longer procedure with a longer recovery time (about six to eight weeks).

What are the possible risks or complications of gallbladder removal surgery?

Surgery always involves some risks, including bleeding, complications of anesthesia, and injury to nearby organs. These risks are low compared to the risks of potential cancer. There are no long-term side effects to having your gallbladder removed.

What’s my prognosis after gallbladder removal surgery?

Most people recover well after having their gallbladder removed and their symptoms won’t return. Your digestive system will continue to function without your gallbladder. Your liver will deposit bile directly into your small intestine without storing it in the gallbladder first. While you may have to limit your fat intake immediately after surgery, most people return to their normal diet after a few weeks.

A note from Cleveland Clinic

Gallbladder polyps take many forms, but the vast majority of them are nothing to worry about. If polyps surprise you by showing up on an ultrasound, they might offer a clue to another condition, but they probably aren’t the cause of your symptoms. If your healthcare provider identifies a polyp that has the potential to turn cancerous, they may recommend removing it, even though the chance is only .5%. If that happens, you’ll do fine without your gallbladder. Most polyps removed this way turn out to be benign, but it’s better to be on the safe side.