Should gallbladder be removed for small polyp(s)?

[terry0116]

I am a 69 year old male. One year ago an ultrsound revealed mulitple small gallbladder polyps. A new ultrasound has just showed only a single small gallbladder polyp according to the reading. My surgeon who advises gallbladder removal quotes the current standard to remove the gallbladder to prevent cancer if there are any small polyps at all.

   My questions are: (1)Should I opt for removal or continue with watchful waiting with yearly ultrasounds? (2)Why would the ultrasound show only one polyp this year? Could I have none next year or is this the imprecision of ultrasounds?

[Kevin Pho, MD]

It is true that the only effective treatment for gallbladder polyps is removal of the gallbladder.  However, this consideration would differ depending on the situation.

First, surgery should be considered if there are gallstones along with the polyp - since this increases the risk of cancer.

If gallstones are not found, polyps larger than 10mm should have surgery performed.  Smaller than 10mm should have close ultrasound followup.  Repeat ultrasound in 3-6 months, then yearly afterwards can be considered.

These options should be discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
Medical Weblog:
kevinmd_b

[surgeon]

It's somewhat controversial: polyps are not rare in the gallbladder, and the vast majority do not become cancerous, and are not of clinical significance. The general feeling is that if they're smaller than 10 mm, they can be left alone unless they're shown to be growing. In addition, it's the case that ultrasound, as you suggested, is imperfect in the diagnosis; some things felt to be polyps turn out to be cholesterol deposits, etc, which might be why your "polyps" reduced in number. Unfortunately, the only way to diagnose accurately it to remove the gallbladder. I'd say there's general agreement that if you have no symptoms, and if the polyp is less than 10 mm in size, it's ok to leave it alone, but to have repeat ultrasounds somewhere between 6-monthly and yearly for awhile to make sure it's not growing.

[GallbladderBaby]

I'd get that gallbladder out to reduce the chances of one of the most lethal forms of cancer in man.
Good luck and may God bless you!
Gallbladder Baby

[dmaclean]

Please don't scare people by using words like lethal.  Let the MD respond or give your personal history.  I received a responce with the word lethal and it sent me into a panic.

[KaseyT]

I'm 63 and had my gallbladder removed about 2 years ago. I also have GERD (reflux). I have been fortunate in that I haven't had any of the problems that many people do after removal. The most common problem, which I do have, is called "bile dumping".  Which means you are going to have to go the bathroom within an hour after eating.  Maybe not all the time but especially after eating a large meal containing a lot of fat.

Since my gallbladder removal I've learned that there are alternatives like Liver and Gallbladder flushes.  If I had known about these I would have tried them prior to removal.

Check out this site for info. http://www.liverdoctor.com/Section4/gallbladder.asp

You may have heard about lemon juice and olive oil flushes but I like this one better.
An Alternative Method for the Liver and Gallbladder flush is:
• Drink one quart (one litre) of organic unsweetened apple juice daily for five days. This will soften up the stones to such an extent that they can be squashed with the fingers. During these five days eat mainly raw fruits and vegetables and no dairy products, red meat or chicken.

• On the sixth day, skip dinner and at 6 p.m. take a tablespoonful of epsom salts with 3 glasses of water. Repeat this at 8 p.m.

• At 10 p.m. make a cocktail of 115ml (4 ounces) of olive oil and 115ml of fresh squeezed lemon juice. Shake this very well and drink immediately.

• Next morning you will pass green stones varying from the size of grains of sand to as large as your thumb nail. You may be amazed at the results, as have many thousands of people who have used this technique to avoid surgery.

Before doing this flush read the preparation that follows it on the web site.

Hope this helps.

[GallbladderBaby]

I understand your perspective on the word lethal, but gallbladder cancer is exactly that, very deadly.  It must be respected as such.  people need to know the truth because a simple cholesectomy can save a life.

[Debbie522]

A related discussion, Should I have my gallbladder removed? was started.

[momfef]

A related discussion, gallbladder polyp and surgery was started.

[Accidentalpro]

I am17 recently had an appedescoptemy and after that I was havin alot of abominal pain I went for a ultra sound scan n it come back saying I had 2 polyps on my gallbladder n my surgian advises me to have my gall bladder remove what should I do?