Surgery should be considered if gallbladder polyps exceed 1cm or increase in size

When gallbladder polyps or gallstones are discovered through a health checkup, anxiety about cancer naturally increases. However, not all polyps are cancerous, and the decision regarding surgery is determined by the patient's condition, the size of the polyp, and accompanying symptoms.

Consider surgery if gallbladder polyps exceed 1cm or increase in size

Professor Son Hee-ju of the Department of Hepato-Biliary-Pancreatic Surgery at Chung-Ang University Gwangmyeong Hospital explains that most gallbladder polyps are in the form of 'cysts' caused by accumulated cholesterol and are unrelated to cancer. However, not all polyps can be left alone. If the size of the polyp exceeds 1cm, if the size continues to increase during follow-up examinations, or if the polyp exists alone in a round shape or is accompanied by gallstones, the possibility of malignancy (cancer) cannot be ruled out, so detailed examinations or surgical resection must be considered. Therefore, if a polyp is discovered, steady follow-up observation through abdominal ultrasound is required at intervals of 6 months to 1 year.

Many patients worry about digestive problems occurring after gallbladder removal. Since the gallbladder functions to store and then release bile, after removal, bile flows out from the liver little by little directly. Due to this, during the first few weeks after surgery, symptoms such as indigestion when eating greasy food or loose stools may appear, but in most cases, the body adapts and improves naturally. Cases of suffering from indigestion for a lifetime are extremely rare.

Pancreatic cancer: expanding surgical opportunities through neoadjuvant chemotherapy

Pancreatic cancer is a disease with a difficult prognosis, with about 50% of cases being in Stage 4, where it has already metastasized to other organs at the time of diagnosis. Only about 20% of cases are in a state where surgery is immediately possible at the time of diagnosis. However, even in cases where surgery is possible, there is an increasing number of cases applying 'neoadjuvant chemotherapy,' which involves performing chemotherapy before surgery to suppress micro-metastasis and lower the risk of recurrence.

In particular, for patients with borderline resectable or locally advanced pancreatic cancer where the cancer is close to major blood vessels, 'conversion surgery' can be attempted, where the tumor size is first reduced through chemotherapy before switching to surgery. Through this, up to about 40% of all patients can obtain the opportunity to undergo surgery. Since pancreatic cancer surgery is a high-difficulty task that requires removing only the cancer tissue while preserving blood vessels, robotic surgery, which provides 3D stereoscopic images and allows for minute movements, is utilized to perform precise resection and reconstruction.

Meanwhile, in the case of asymptomatic gallstones, regular follow-up observation is usually sufficient. However, surgery may be necessary even without symptoms if the gallstones are larger than 3cm, if they are accompanied by gallbladder polyps, if gallbladder cancer is suspected, if it is a porcelain gallbladder where the gallbladder wall is calcified, or if there is a congenital biliary tract malformation.