Are They Cancerous?
Gallbladder polyps are small growths that developed from the inside lining of the gallbladder. Most gallbladder polyps are found incidentally during an abdominal ultrasound or other radiographic modalities.
Most polyps are benign an will never become cancerous. Most reports quote that 95 % of all gallbladder polyps are non-malignant. The most useful predictive factor for malignancy is the size of the polyp. A gallbladder polyp larger than 20 mm is highly concerning for malignancy.
Polyps between 10-20 mm in size have the potential for becoming malignant. Several studies quote a 40-70 % chance of becoming malignant over time.
Small gallbladder polyps below 10 mm in size have a low risk of malignancy.
Another risk factor is the patient’s age. Patients older than 50-60 years of age are associated with a higher rate of malignant polyps.
If you were diagnosed with gallbladder polyps it is recommended that you see a qualified physician that can determine if further treatment is required.
Can They Cause Symptoms?
Like gallbladder stones, most gallbladder polyps are asymptomatic. Symptoms could be developed and they usually mimic those of gallbladder stones. Pain in the right side of the abdomen tends to be the most common complaint. The pain often radiates to the right shoulder or the middle of the back. Other symptoms could be nausea, vomiting, bloating, diarrhea, indigestion, heartburn and/or chills.
Advances in diagnostic imaging have resulted in improved detection of gallbladder polyps. Unfortunately, imaging alone can not determine the risk or presence of malignancy.
Transabdominal ultrasound is the gold standard for detecting gallbladder polyps. They can be easily detected by a good technician or radiologist. Most of the time they can also distinguish them from gallbladder stones.
CT scans have low sensitivity for detecting small gallbladder polyps and is mainly reserved for larger polyps or for staging in cancer cases.
PET CT scans are only used in the setting of malignancy and they are usually used to look for metastatic disease.
Endoscopic Ultrasounds (EUS) are more sensitive than transabdominal ultrasounds but they are more invasive and they are not readily available. Most of the time a EUS is reserve when malignancy is suspected and a closer look is warranted for staging or to plan surgical intervention.
What Is The Treatment?
The only effective treatment for Gallbladder Polyps is laparoscopic gallbladder removal surgery (cholecystectomy). Polyp surveillance with frequent ultrasounds can be considered in some patients.
- Patients with concomitant gallbladder stones and polyps should undergo cholecystectomy. Some studies have suggested an increased risk of malignancy in these patients regardless of the size of the polyp.
- Gallbladder polyps larger than 20 mm should be staged with CT scan and/or Endoscopic ultrasound due to high risk of malignancy. They should undergo surgery after adequate workup.
- Gallbladder Polyps between 10-20 mm in size have a potential for malignancy and laparoscopic cholecystectomy should be performed.
- Polyps less than 10 mm in size can be closely followed up with ultrasound every 6 months for the first 12-24 months and then yearly.
- Patients with polyps and gallbladder symptoms should have gallbladder removal surgery.
Laparoscopic Gallbladder Surgery
What If I Had Previous Open Surgery?
Patients with a prior history of open surgery might not be a candidate for a laparoscopic approach with other surgeons. Dr. Angel Caban has extensive experience with complex laparoscopic intraabdominal surgery. Most patients will be a candidate for laparoscopic gallbladder removal surgery in the hands of Dr. Caban.
Recently Dr. Caban completed a gallbladder removal surgery laparoscopic in a patient with a prior history of a gunshot wound to the abdomen requiring multiple abdominal surgeries.
In cases like the one above you should expect to have a longer operative time and/or more than 4 small incisions but even in that case your recovery will be faster and you will have less pain than if your surgery was done open.
What Happens After Gallbladder Surgery?
After surgery, you will be in the recovery room for 2-3 hours. You will be discharged home with several days supply of pain medication. Most patients that have office type job can expect to return to work after 3-4 days. For those of you that have a heavy labor job were heavy lifting more than 15-20 pounds is necessary, you should account for 4-6 weeks out of work.
You will follow up with Dr. Caban in 2-3 weeks. At that time you will get the results of the gallbladder pathology. Gallbladder cancer is very rare but approximately 1% of all gallbladder surgeries will be positive for cancer.
Most patients won’t notice any changes from not having the gallbladder. A small percentage of patients will experience transient or chronic diarrhea especially after eating a high-fat diet. Most patients will go back to eat a normal diet, but some will need to limit the fat content on their diet.
What People are Saying
“Dr. Angel Caban performed my surgery almost 5 years ago on 6/2/2014. He is a kind doctor and always treated me fairly. I always felt welcome in his office. I recommended him to many over the past 5 years”.
“Me encanta no lo cambio. Exelente el doctor caban y su personal. Muy buen grupo”.
“Another successful experience”
“Dr. Caban did my colon resection and did an outstanding job all the way across the board. I highly recommend him as well”.
“Very fortunate to have him”
“I have the privilege of working with Angel M Caban in the hospital environment. I also have had him be the surgeon to one of my family members. I would like everyone to know that he is a great surgeon. We are fortunate to have him here in Ocala. He is personable, easy to talk too and has excellent bedside manners”.
Hours of Operation
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8:00am – 12:00pm
1:00pm – 5:00pm
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