Gall Bladder Polyps

To understand what the gall bladder is, it is important to understand some basics about the digestive system.

Food goes from the mouth to the stomach through the oesophagus. If moves from the stomach to the small bowel then the large bowel where undigested food is excreted from the anus.

The small bowel is divided into three parts: the duodenum, jejunum and ileum.

When food moves from the stomach into the duodenum, it mixes with bile and pancreatic juices which break down the food further so that it can be absorbed into the blood stream through the wall of the small intestine.

The pancreas secretes its enzymes into the duodenum through its pancreatic duct – a channel which links the pancreas to the duodenum.

Bile is a substance made by the liver and is important for the digestion of fat. It enters the duodenum through a channel which connects the liver to the duodenum called the bile duct.

Some of the bile is stored into the gall bladder (which comes off the side of the bile duct).

When a fatty meal is ingested, the gall bladder contracts to deliver some ready-made bile from the gall bladder into the duodenum.

If the gall bladder is removed surgically, bile still travels normally from the liver into the duodenum through the bile duct.

Gall bladder polyps are outgrowths that arise from the lining of the gall bladder.

They are benign growths. However, certain features of gall bladder polyps have a higher risk of malignancy (gall bladder cancer).

Gall bladder polyps are usually asymptomatic unless they are located at the neck of the gall bladder where they can cause obstruction and thus become symptomatic.

They are usually detected incidentally on an ultrasound scan.

If the gall bladder polyps have high risk features that increase the risk of gall bladder cancer, the gall bladder should be removed (cholecystectomy).

The indications for operating on gall bladder polyps include size >10mm, male >50, single polyp, associated gall stones and family history of gall bladder cancer.

Smaller gall bladder polyps are usually followed up with an ultrasound.