Is surgery necessary for my 4mm gallbladder polyp with stone?

Question

Hello doctor,

My recent ultrasound of the gallbladder showed a 4 mm polyp, a 0.6-inch stone, and a small amount of sludge. Though I am asymptomatic, I visited my gastroenterologist. His opinion was that, though rare, having a stone and polyp increases my risk of malignancy, and suggested removal.

I am very hesitant to remove and seek your input regarding the increased malignancy risk.

Would Ursodiol be useful?
If so, how long would it take to work?

Kindly guide.

Answer 1

Hello,

Welcome to icliniq.com.

Yes, Ursodeoxycholic acid can be tried for three months. But it is effective only in about 40 percent of the cases. A gallstone, even if asymptomatic, should be removed through surgery because if somehow it slips into the bile duct, then it will block the pancreatic duct, causing the symptoms of pancreatitis.

Pancreatitis is a medical emergency that can be fatal. Hence, gallbladder stones should be removed laparoscopically at the earliest.

I hope this helps.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

Yes, a polyp and a stone at the same time can increase the chance of malignancy in the future by about 0.5 to 1 percent. Practically, I have performed almost 2000 cholecystectomies, and the only problem patient usually face is that they have to limit their fat intake. However, there are many complications, yet they are very rare.

Sex has nothing to do with increased risk. Please attach the printed reports of the ultrasound of your abdomen to know the location of the polyp, stone, and its proximity to the bile duct.

Feel free to reach out in case of further queries.

Thank you.

Answer 3

Hello,

Welcome back to icliniq.com.

Have seen all the reports and photos attached (attachment removed to protect the patient's identity). The size of the stone is small. Actually, small stones are more dangerous than large stones, because the chances of them slipping out of the gall bladder into the common bile duct are very high, and this can lead to a number of complications, which can be even life-threatening.

Sludge is also present in the gall bladder, which will further crystallize into new stones. My suggestion is to get the gall bladder removed and stay away from any tension.

I hope this information helps you.

Thank you.

Answer 4

Hello,

Welcome back to icliniq.com.

Polyps less than 0.3 inches are usually nonmalignant, so do not worry about malignancy. The location of the stone is in a non-dependent part, which means on the other side of the bile duct; however, the location of the stone varies with movements because the stone, unlike a polyp, is not fixed.

Urodeoxycholic acid 300 mg (milligrams) twice daily can be tried for three months if you do not want to go for surgical procedures.

I hope this helped.

Feel free to reach out in case of further queries.

Thank you.