Gallbladder polyp

Section: Hepatobiliary Sub-section: Biliary Curriculum: Curriculum, page 88

Definition

Gallbladder polyps are outgrowths of the gallbladder mucosal wall

Epidemiology

• Common
• Gallbladder polyps have been observed in 1.5 to 4.5 percent of gallbladders assessed by ultrasonography and up to 13.8 percent of resected gallbladders

Aetiology

• Benign polyps
  • Non-neoplastic
    • Cholesterol - most common, not pre-cancerous
    • Inflammatory
    • Adenomyomatosis of the gallbladder
      • Overgrowth of the mucosa, thickening of the muscle wall, and intramural diverticula.
  • Neoplastic
    • Adenomas
      • Risk of cancer increases with size
    • Other - Fibromas, lipomas, leiomyomas
• Malignant polyps
  • Adencarcinomas

Risks for cancer

• Size >1cm
• PSC
• Sessile polyp
• Asian ethnicity
• Age >60
• Sessile polyps (wide base) and >4 mm focal gallbladder wall thickness.

Management

European Society of Gastrointestinal and Abdominal Radiology (ESGAR), European Association for Endoscopic Surgery and other Interventional Techniques (EAES), International Society of Digestive Surgery–European Federation (EFISDS) and European Society of Gastrointestinal Endoscopy (ESGE) https://link.springer.com/article/10.1007/s00330-021-08384-w