Gallbladder Polyps

Gallbladder polyps are growths in the lining of your gallbladder. They can form from cholesterol buildup, inflammation and abnormal cell growth.

Most gallbladder polyps aren’t cancerous and don’t cause symptoms. But in rare cases, they can turn into cancer.

Providers often find gallbladder polyps during tests for other reasons. You may also have imaging if you have symptoms like pain in the upper right side of your abdomen and nausea.

Your provider may watch your gallbladder polyps with follow-up visits. If the polyps cause symptoms or may be cancer, they may recommend surgery to remove your gallbladder.

Types of gallbladder polyps

There are two main types of gallbladder polyps: pseudopolyps and true polyps.

Pseudopolyps

Pseudopolyps, or “false polyps,” are the most common type. They aren’t cancerous and make up about 70% to 90% of cases.

Types of pseudopolyps include:

• Cholesterol foci: Small cholesterol deposits stick to your gallbladder lining. They’re the most common type of gallbladder polyp and aren’t cancerous.
• Adenomyomatosis: Tiny pouches form in the gallbladder lining and make it thicker. Experts don’t know the exact cause, but it may be linked to changes in how your gallbladder wall develops. It’s considered harmless.
• Inflammatory polyps: Ongoing inflammation of the gallbladder can cause scar tissue that forms these polyps.

True polyps

True polyps are growths made of cells that keep growing when they shouldn’t.

A common type is adenoma. Adenomas are made of cells similar to those in your bile ducts. Most aren’t cancerous, but a small number can turn into cancer.

Other noncancerous types include:

• Lipomas
• Fibromas
• Leiomyomas

Cancerous polyps, like adenocarcinomas, are rare.

Symptoms of gallbladder polyps

Gallbladder polyps usually don’t cause symptoms. You may not know you have them until a healthcare provider finds them during a test for something else.

If symptoms do happen, they might include:

• Upper right abdominal pain that can come and go
• Nausea and vomiting
• Fever (if the gallbladder or bile duct becomes inflamed)
• Trouble digesting fatty foods

In rare cases, a cancerous polyp can block bile flow and cause jaundice.

Causes of gallbladder polyps

The cause depends on the type of polyp.

Pseudopolyps can form from cholesterol buildup or long-term inflammation. True polyps form when cells in your gallbladder lining grow more than they should.

Risk factors

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

• Cholangitis
• Cholecystitis
• Familial adenomatous polyposis (FAP)
• Gallstones
• Hepatitis B
• High cholesterol
• Peutz-Jeghers syndrome
• Primary sclerosing cholangitis (PSC)
• Obesity or metabolic syndrome

Your risk also increases with age, especially after 50.

These factors raise your risk of cancerous polyps:

• Age over 60
• Asian ancestry
• Primary sclerosing cholangitis (PSC)
• Polyps larger than 10 millimeters (mm)
• A single polyp (rather than many)
• A flat or broad-based (sessile) shape

Thickening of your gallbladder wall can also increase cancer risk.

Complications of gallbladder polyps

Most gallbladder polyps don’t cause problems. But if symptoms develop, they can get worse over time without treatment.

Cancerous polyps can spread outside your gallbladder and affect other parts of your body.

How doctors diagnose gallbladder polyps

Providers often find gallbladder polyps during imaging tests done for other reasons. But if your provider thinks there is an issue with your gallbladder, they’ll likely order an ultrasound. This test uses sound waves to create images of your gallbladder.

If the ultrasound findings aren’t clear, your provider may order an endoscopic ultrasound (EUS). This test gives a closer, more detailed view and can help tell the difference between harmless and potentially dangerous polyps.

Providers look at the number, size and shape of the polyps. Cancerous polyps are more likely to appear as a single growth, while noncancerous polyps often appear in groups.

How are gallbladder polyps treated?

If you have symptoms, your healthcare provider may recommend surgery to remove your gallbladder.

Laparoscopic cholecystectomy is the most common surgery to do this. Surgeons make a few small cuts to insert a tiny, lighted camera and tools to remove your gallbladder.

Your provider may recommend an open cholecystectomy if they think the polyps may be cancer. In this procedure, your surgeon makes a larger cut under your right ribcage to remove your gallbladder, nearby tissue and lymph nodes if needed.

The gallbladder isn’t like your brain or your heart. It might take some getting used to, but you can live a full life without it.

Most people don’t have symptoms. In that case, treatment depends on polyp size and your risk for cancer:

When should I see my healthcare provider?

Reach out to your provider if you start having symptoms. They can check your polyps and decide if you need follow-up or treatment.

It’s normal to feel concerned if you learn you have gallbladder polyps. Your provider can walk you through what it means and what to do next.

Your provider may also talk with you about surgery. While it may seem like a big step, it can lower your risk of cancer or prevent it from spreading.

What can I expect if I have gallbladder polyps?

Most gallbladder polyps don’t go away on their own — though, some small cholesterol polyps may shrink or become undetectable over time. But they usually don’t cause problems and aren’t cancerous. You may never know you have them.

If a polyp is cancerous, early care can make a big difference. Treatment for gallbladder cancer may include surgery and other cancer therapies. Your provider will talk with you about what to expect and the best options in your situation.

How fast do gallbladder polyps grow?

Most polyps grow slowly. A single polyp usually grows less than 1 to 2 mm per year. Many stay the same size or even shrink.

Cancerous polyps may grow faster. If your polyps grow quickly, your healthcare provider may recommend surgery.