How are gallbladder polyps diagnosed and treated?

This is an automatically translated article.

The article is professionally consulted by Master, Doctor Vu Huy Binh - Department of Medical Examination & Internal Medicine - Vinmec Hai Phong International General Hospital. Doctor has 09 years of experience in the field of Gastrointestinal Endoscopy.
Gallbladder polyp is a neoplasm or pseudotumor that develops on the surface of the gallbladder lining. Gallbladder polyps are quite common and can appear at any age. So how to diagnose and treat gallbladder polyps, please follow the article below.

1. Diagnosis of gallbladder polyps

1.1 Clinical symptoms

Function: often vague, less aggressive, only clinical manifestations when polyps cause secretion disorders, bile secretion in the gallbladder lumen or gallbladder stones or accompanying cholecystitis. Mild pain in the right lower quadrant or epigastrium, pain often appears after eating, may be fullness, indigestion, nausea and vomiting. Body as a whole: The patient usually has no fever and no signs of biliary obstruction. Physical examination: Abdominal examination may show mild pain in the right lower quadrant, most of which do not detect any abnormality. Examine other organs for comorbidities.

1.2 Subclinical

Abdominal ultrasound: this method is useful for screening gallbladder diseases: gallstones, gallbladder polyps. Gallbladder polyps on ultrasound are hyperechoic, without shadow. Ultrasound allows the identification of polyps, location, size and shape of polyps (pedunculate or pedunculated), helping to monitor the progression for appropriate treatment. The accurate diagnosis rate of ultrasound for gallbladder polyps is over 90%.

Oral Contrast Cholangiography: The polyp is shown as a contrast enhancement in the gallbladder that has been enhanced by the drug. Endoscopic retrograde cholangiography: this method is often indicated when ultrasound of the biliary tract fails. Computed tomography (CT scanner - MSCT scanner): applied in cases of large polyps with risk of malignancy. The image of polyp lesions in computed tomography is an increased density protruding into the gallbladder lumen. Contrast-enhanced CT helps diagnose almost 90% of the time. Magnetic resonance imaging (MRI): This method is indicated when polyp lesions are suspected of malignancy. On MRI, the polyp is an hyperintense mass in the T2 phase. Biochemistry: assessment of liver and kidney function, hepatitis virus test (HCV, HbsAg...), tumor immunity (CEA, CA 19-9).

2. Gallbladder polyp treatment

About 92% of gallbladder polyps are benign (non-cancerous) in nature, so patients do not need surgical intervention to remove the gallbladder.
Small polyps less than 10mm (or less than 15mm) can only need regular monitoring every 3-6 months without surgery to remove the gallbladder. Polyps larger than 10mm have the potential to progress to cancer, especially those larger than 15mm, so cholecystectomy may be recommended to prevent gallbladder cancer growth. Doctors agree on a treatment protocol for gallbladder polyps as follows:
If gallbladder polyp is suspected by ultrasound, but the patient has no symptoms such as pain, fever, etc., it should be re-examined later. 6 -12 months to confirm.

If after that time there are no pictures of polyps, there is no need to do anything. In case the polyp image is clear, it is necessary to periodically follow up with ultrasound every 6 months if the tumor is larger than 10mm, or there are malignancies detected by blood tests, other investigations or the polyp has had clinical manifestations. such as recurrent fever and pain, early surgery is indicated. Early diagnosis and detection of gallbladder polyps is very important for doctors to give appropriate treatment, making the treatment of gallbladder polyps more satisfactory. Therefore, you should proactively visit a reputable hospital when you see any unusual signs that suspect gallbladder polyps.

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