Gall bladder polyps

 

Gall bladder polyps

Gallbladder polyps are masses of cells that are seen on the inner lining of the gallbladder. Most are benign asymptomatic incidental findings (found on USG). However, a small percentage (0.5-2%) may be cancerous. In such cases, early is key for curative treatment and long-term survival.



Types of Polyps

1.      Benign

a)      pseudo-tumors (cholesterol polyps, inflammatory polyps; cholesterolosis and hyperplasia)

b)      epithelial tumors (adenomas) and

c)      mesenchymatous tumors (fibroma, lipoma, and hemangioma).

2.      Malignant-  Gall-bladder carcinomas.

Are they harmful?

As mentioned previously, most are asymptomatic and benign; but in some cases, as a result of mechanical obstruction in the biliary tree, they have the potential to produce

1.      Cholecystitis

2.      Cholangitis

3.      Pancreatitis

Gall-bladder cancer is an extremely aggressive cancer. Average survival with treatment is 3-5 years. Therefore, early diagnosis in pre-malignant stage helps prevent mortality.

Risk factors associated with GB polyps

1.      Gallstones

2.      Age over 50 years

3.      High triglycerides or cholesterol

4.      Peutz-Jeghers or Familial adenomatous polyposis syndromes

 

Tests for evaluation

1.      Endoscopic ultrasound

2.      Trans-abdominal ultrasound

Management

1.      After careful evaluation, risk-assessment is done and further steps are planned

2.      Low-risk or benign polyp after evaluation- Regular follow-up with gastroenterologist

3.      High-risk of malignancy- Cholecystectomy

 




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