Most gallbladder polyps are harmless and found by chance on an ultrasound. Their size, and a few risk factors, decide whether you need repeat scans, surgery or nothing at all.
A gallbladder polyp is a small growth that sticks out from the inner wall of the gallbladder. Polyps are common: ultrasound studies find them in roughly 4 to 7% of adults. Most are harmless cholesterol polyps that never cause trouble. A small number can become cancerous, and the risk rises with size.
A polyp is different from a gallstone. A polyp is attached to the gallbladder wall and stays in place when you change position during an ultrasound scan. A gallstone is loose inside the gallbladder, moves when you turn, and casts a shadow on the scan.
Also called pseudopolyps. The most common type: deposits of cholesterol on the gallbladder lining.
Form after irritation of the gallbladder lining.
True polyps. Less common. An ultrasound can’t always tell the types apart, so size and risk factors guide treatment.
Usually not. Here is how most polyps come to light, and what pain usually means.
Most gallbladder polyps cause no symptoms at all.
They are usually found by chance on a scan done for something else, such as a health screening.
Pain under the right ribs, nausea or bloating after fatty meals is more often caused by gallstones.
If your symptoms can’t be explained any other way, removing the gallbladder may still be advised.
Doctors use the polyp’s size and your risk factors to decide between surgery, follow-up scans or no follow-up. These are the risk factors that count:
| Polyp size | No risk factors | One or more risk factors |
|---|---|---|
| 10 mm or larger | Remove Gallbladder removal recommended | Remove Gallbladder removal recommended |
| 6–9 mm | Scan Ultrasound at 6 months, 1 year and 2 years | Remove Gallbladder removal recommended |
| 5 mm or smaller | No follow-up No follow-up usually needed | Scan Ultrasound at 6 months, 1 year and 2 years |
If a polyp grows to 10 mm during follow-up, removal is advised. If it grows by 2 mm or more within two years, your surgeon will weigh its size and your risk factors to decide whether removal is needed. Because Asian ethnicity is listed as a risk factor, many patients in Singapore fall into the risk-factor column, which is one reason to have a polyp reviewed by a specialist rather than left alone.
Based on the joint guidelines of ESGAR, EAES, EFISDS and ESGE (Foley KG et al., European Radiology, 2022).
No medicine or diet has been shown to shrink a gallbladder polyp. When treatment is needed, the gallbladder is removed (cholecystectomy). Dr Kan Yuk Man performs gallbladder removal surgery by keyhole (laparoscopic) technique.
Ministry of Health fee benchmark for cholecystectomy (SF801G), including GST, for uncomplicated surgery. Complicated cases have a higher benchmark, and hospital charges are separate.
Gallbladder surgery is claimable under MediSave and Integrated Shield plans, and Dr Kan is on several Shield plan specialist panels.
Short answers to what patients most often ask after a polyp shows up on their scan.
Most are not. The majority are cholesterol polyps, which are harmless. The risk is in larger polyps, especially those of 10 mm and above, and in people with risk factors such as age over 60 or Asian ethnicity.
Polyps of 10 mm or larger are usually removed. Polyps of 6 to 9 mm are removed if you have a risk factor; otherwise they are checked with ultrasound at 6 months, 1 year and 2 years.
Some cholesterol polyps stay the same size for years, and some are no longer seen on later scans. Follow-up scans show which group yours belongs to.
No diet or medicine has been shown to shrink them. A balanced diet is good for gallbladder health, but it doesn’t replace follow-up scans.
A polyp is attached to the gallbladder wall; a stone is loose inside the gallbladder. On ultrasound, a stone moves when you change position and casts a shadow, while a polyp does not.
Usually not. Pain is more often caused by gallstones. If you have pain and a polyp, a surgeon can work out which one is responsible.
Yes, if the polyp is 6 mm or larger, if it has grown, or if you have a risk factor. Bring your ultrasound report so the size and appearance can be reviewed against the guideline.
Bring your scan report to a consultation with Dr Kan Yuk Man, senior consultant surgeon, at Mount Elizabeth Orchard or Farrer Park Hospital.
