Management of Incidentally Detected Gallbladder Polyps

Gallbladder polyps are seen in about 5% of patients who undergo abdominal ultrasound. The majority of gallbladder polyps are nonneoplastic (cholesterol or inflammatory polyps), and about 30% actually represent small stones misdiagnosed as polyps. The main concern is the rare gallbladder carcinoma, which has a poor prognosis (5-year survival rate of approximately 10%).

The risk of malignancy increases for polyps larger than 10 mm, sessile polyps, single polyps, and polyps with adjacent wall thickening or invasion, and with increasing patient age.

The most recent data suggest that incidentally detected gallbladder polyps ≤ 6 mm may require no additional follow-up. While the data are inconclusive in regards to management of polyps > 7 mm in diameter, cholecystectomy seems to be warranted for lesions > 10 mm.

References

• Corwin MT, Siewert B, Sheiman RG, Kane RA. Incidentally detected gallbladder polyps: is follow-up necessary?--Long-term clinical and US analysis of 346 patients. Radiology. 2011 Jan;258(1):277-82.
• Ito H, Hann LE, D'Angelica M, Allen P, Fong Y, Dematteo RP, Klimstra DS, Blumgart LH, Jarnagin WR. Polypoid lesions of the gallbladder: diagnosis and followup. J Am Coll Surg. 2009 Apr;208(4):570-5.