Gallbladder Polyp : Are These Indications For Gallbladder Removal?
                     Gallbladder Polyp 
Gallbladder Polyp 
    Gallbladder polyps are gallbladder wall elevations that project into the lumen. Commonly 
detected on ultrasound done for other symptoms. Incidence vary from 0.3 to 9%
As the incidence of polyp is more and chances of malignancy is rare, selective surgery is 
done for these patients and should be counselled accordingly.
Symptoms  & Diagnosis
            As the gallbladder polyp are attached to gallbladder wall and are non-mobile these do not cause 
any symptoms. Large polyps because of there size and twisting effect or when change 
into cancer may cause pain. 
     Ultrasound abdomen is the most common investigation for diagnosis.It will detect the number 
and size of polyp. CECT abdomen is done when USG show suspicious of gallbladder cancer.
Indication of Surgery
              The only indication for surgery in gallbladder polyps is risk of cancer. It 
is said that risk of cancer is high in polyp size more than 10mm, single 
polyp and sessile polyp
For Polyp less than 6mm follow up ultrasound is done at 1, 3 and 5 year. 
For polyp 6-9 mm ultrasound is done at 6 months, 1,2,3,4 and 5 year; If 
during follow up increases by 2mm or more cholecystectomy is advised
For polyps 6-9mm if there are risk factors for gallbladder malignancy like 
age > 50 years, sessile polyp, indian ethinicity, PSC then also 
cholecystectomy is advised.
Surgery for gallbladder polyp
       Laparoscopic cholecystectomy is the standard surgical 
procedure for gallbladder polyp. Advantage of laparoscopy 
surgery being early recovery and discharge from the hospital. If 
investigations suggest cancer doubt in polyp then it should be 
treated like gallbladder cancer. Intra-op frozen section should 
be sent from suspicious area and should proceed accordingly.
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