Gall bladder polyps, previously called cholesterolosis is being increasing diagnosed on ultrasound scan, quite simply because the scanners today are so much better than they were ten year ago. This is causing increasing and often unnecessary anxiety in patients. The prevalence of Gallbladder polyps (GBPs) is estimated at ~5% in the global adult population,but I suspect it is higher now that better ultrasound scan machines are used.

Your doctor has told you that you have gall bladder polyps:

Should you be worried? No

Can gall bladder polyps become cancerous? Yes they can, but rarely.

So how worried should I be, now that I have gall bladder polyps? Most gall bladder polyps are small and inconsequential and if <4mm in size, they are virtually NEVER malignant.

When do doctors become worried about gall bladder polyps? When they approach or exceed 1cm in size. Gallbladder polyps that are 1cm (10mm) in asymptomatic patients less than 50 years old have a low risk of malignancy, and therefore, a careful “wait and see with follow up by using ultrasonography strategy” might be more appropriate than immediate cholecystectomy. However, at present we just don’t know the risk. The choice is between regular surveillance ultrasound scan or cholecystectomy.

So what do I do? Until we know more about the natural history of gall bladder polyps the current advice is regular imaging by ultrasound, with laparascopic cholecystectomy if needed (gall bladder polyp >1cm in size and age >50 years). If I was in my 40’s (I wish I was) with a 1cm gall bladder polyp what would I do? I think I would opt for a laparascopic cholecystectomy. I say this because we know that up to 5% of such polyps become malignant or are malignant, and monitoring just causes extra stress but no resolution. But the choice is between you and your surgeon/physician.