Gallbladder polyps: Diagnosis and treatment

Gallbladder polyps are relatively common in adults and affect approximately 5% of the population. Polypoid lesions of the gallbladder are asymptomatic and are detected during abdominal ultrasonography performed for unrelated conditions. Although the majority of gallbladder polyps are benign, malignant transformation is a concern. The differentiation of benign from malignant lesions can be challenging. Several features, including polyp size, number, rapid growth, sessile lesion, patient age and gallbladder wall thickening are important discriminating features between benign and malignant polyps and may increase the risk of gallbladder cancer. Histopathologic analysis of polypoid lesions of the gallbladder continues to be the gold standard to identify malignancy. Ultrasound has been used extensively in the pre-operative management of these lesions, but modern ultrasound techniques are unable to differentiate between benign and malignant polyp of the gallbladder with any certainty. We recommend surgical treatment of polypoid lesions of the gallbladder in symptomatic patients, as well as in asymptomatic individuals over 50 years of age, or those whose polyps are solitary, sessile, greater than 6 mm in diameter, that demonstrate rapid growth, vascularity and invasion or are associated with gallstones.