Skip to main contentShah's Gastro, Cancer & Robotic Surgery Centre · Ahmedabad & Gandhinagar
Last updated: 21-Oct-2026
Gallbladder polyps, adenomyomatosis and the calcified (porcelain) gallbladder · Gota, Ahmedabad · Apollo Hospital, Bhat, Gandhinagar
A polyp on an ultrasound report is a small raised spot on the gallbladder lining. Most are cholesterol deposits, not tumours, and never turn into one.
A few are true growths that can become cancer. Size, shape, number and your own risk factors decide whether the gallbladder is removed or watched.
A polyp of 10 mm or more is removed. Below that the decision turns on shape, growth and risk, not on the millimetre alone.
A polyp decision needs an ultrasound read properly, the option of better imaging, and a surgeon who can do either operation the finding may call for.
Shah’s Gastro, Cancer & Robotic Surgery Centre. Two higher degrees in surgery of the digestive system, and 18 years of experience in gallbladder, bile duct and liver surgery. Ultrasound, better imaging when it is needed, keyhole surgery, the cancer operation and pathology sit in one pathway, so a borderline polyp does not travel between centres while the months pass.
Dr Harsh Shah
MS, MCh (Surgical Gastroenterology), DrNB (Surgical Gastroenterology)
Registered with Gujarat Medical Council, Reg. No. G-38738
Gallbladder Surgeon · Apollo Hospital, Bhat, Gandhinagar · Gota, Ahmedabad
On ultrasound a polyp is a fixed lump on the lining that casts no shadow. A stone moves when you turn, and casts a shadow behind it.
| What the lining shows | Is it a growth? | How it usually looks on the scan |
|---|---|---|
| Cholesterol polyp, also called a pseudopolyp. | No. It is a deposit, not a tumour. | Small, often several, on a stalk, bright, with a comet tail behind it. |
| Adenomyomatosis. | No. It is a change in the wall itself. | Thickened wall at the base or in a segment, with tiny cysts inside it and a comet tail. |
| Inflammatory polyp. | No. It is scar and healing tissue. | Small, no special features, in a gallbladder with long-standing stones. |
| Adenoma. | Yes, and it is the one that can turn into cancer. | Usually single, broadly based or sitting flat against the wall. |
| Polypoid early cancer. | Yes. | Single, flat-based, over 10 mm, with blood flow in it and the wall layers broken at that point. |
Ultrasound answers most questions. Extra imaging is for the single polyp of middle size where the reassuring features are missing.
10 mm is the line at which a polyp is removed. Between 6 and 9 mm the risk factors decide. At 5 mm and under the polyp is watched.
| Size on ultrasound | What is advised |
|---|---|
| 10 mm or more. | The gallbladder is removed, whatever else the scan shows. |
| 6 to 9 mm, with any risk factor from the list below. | The gallbladder is removed. |
| 6 to 9 mm, with no risk factor. | Watched with ultrasound at six months, one year and two years. |
| 5 mm or less. | Watched, less intensively. Stable small polyps can be signed off at two years. |
| Any polyp that grows by 2 mm or more, crosses 10 mm, or gains a new risk factor. | The gallbladder is removed. |
| Single, flat-based polyp over 18 to 20 mm, or a broken wall layer, or a lump. | Worked up and planned as a possible cancer, not listed for a routine removal. |
The honest limit of the rule: most polyps that reach 10 mm are still harmless, and a few true growths are smaller than that.
Any one of these turns a 6 to 9 mm polyp into an operation, because each one raises the chance that the polyp is a real growth.
Watching is an ultrasound at six months, one year and two years, with a written plan and a clear list of what ends it early.
| When | What is done, and what would change the plan |
|---|---|
| Six months after the first scan. | Ultrasound. The largest polyp is measured against the first reading and the wall is checked. |
| One year. | Ultrasound again. Growth of 2 mm or more, or a new flat base, ends the watching. |
| Two years. | Ultrasound. If nothing has changed, the scans can stop and you are signed off. |
| At any point, attacks of pain under the right ribs. | The gallbladder is removed on symptom grounds. |
| If you cannot reliably come back for scans. | Removing the gallbladder is the safer plan, and that is said openly rather than left unsaid. |
Watching only works if the scans happen. Being lost to follow-up is the real way this plan fails, not the polyp growing.
Taking out a gallbladder for a cholesterol polyp is an operation and a risk taken for nothing. Most polyps need reassurance, not a date.
| What the scan shows | What is done instead of an operation |
|---|---|
| Several small bright polyps with comet tails, no symptoms. | Reassurance, and at most one confirming scan. These are cholesterol deposits. |
| Adenomyomatosis with no lump and no focal mass. | Reassurance. It is a change in the wall, not a tumour. |
| A polyp of 5 mm or less, stable. | Light watching, and signing off at two years. |
| A 4 mm polyp in a patient in their eighties. | Reassurance. An operation at that age for that finding would be the greater risk. |
| Dyspepsia and bloating, with a small polyp found by chance. | Another cause for the symptoms is looked for. A small polyp does not explain them, and removing the gallbladder will not settle them. |
A calcified gallbladder wall is the end stage of years of inflammation. It carries a cancer risk, far smaller than once taught, and it is usually removed.
| What the report says | How it is read now |
|---|---|
| A calcified wall, no lump, no symptoms. | Some cancer risk, much lower than the figure taught for decades. Removal is still the usual advice. |
| Calcium in one patch rather than all the way round. | A soft warning sign, mostly because patchy calcium tends to sit beside a lump. Looked at closely, not stratified on. |
| A calcified wall with a lump, or thickening at one spot. | Treated as a possible cancer. Imaged fully and planned as a cancer operation. |
| Yellow eyes without pain, or weight loss, alongside a calcified wall. | These are the findings that genuinely predict cancer, and they describe advanced disease. Urgent full work-up. |
| Neither a lump nor those symptoms, in a frail patient. | Genuinely reassuring. Watching is a defensible shared decision here, and only here. |
A polyp without features of invasion needs a standard keyhole removal. A gallbladder suspected of cancer needs a larger, planned operation from the start.
For the great majority, the operation is the ordinary one: the whole gallbladder removed through keyhole ports, or with the robot where that is the better fit, as a day case or an overnight stay. The whole gallbladder comes out, not the polyp, because a polyp cannot be shelled off a lining and a gallbladder left behind simply makes more of them. Two details are not optional even in a routine case. The gallbladder is handled gently and lifted out inside a retrieval bag, so nothing spills if the lining holds more than expected. And it is opened, inspected and sent for examination under the microscope, every time.
| What the work-up shows | The operation that is planned |
|---|---|
| Polyp of 10 mm or more, or 6 to 9 mm with a risk factor, no sign of invasion. | Standard keyhole removal of the whole gallbladder, lifted out in a bag, sent for examination. |
| Stones and a polyp together. | The same operation. The pair settles the question. |
| Calcified wall, no lump. | The same operation, with care taken because a scarred wall can make the dissection harder. |
| Single flat-based polyp over 18 to 20 mm, a wall layer broken, or a lump. | A radical removal, planned in advance: the gallbladder with the liver bed it sits on and the nodes around it. |
| A cancer already evident on imaging. | Staged and planned on the cancer pathway, which may begin with treatment before any operation. |
| Cancer found only on the report, after an ordinary removal. | From a certain depth of invasion onwards, a second and larger operation is discussed within two weeks at a liver and bile duct unit. |
The one thing that must not happen is a suspected cancer removed as routine work: opened, grasped hard, spilled, and its stage made unreadable.
The risks here are those of a gallbladder removal, and they are named plainly. Your own figures are given in person, before you sign anything.
After a gallbladder operation these four signs are not waited on. Any of them needs the team the same day.
| Sign | What it may mean |
|---|---|
| Fever in the first days. | A bile leak or a collection. It needs a scan and blood tests, not a course of tablets at home. |
| Pain that is getting worse instead of better. | A leak, a collection, or bleeding. |
| Vomiting that is green or bile-stained. | A leak or an obstruction. |
| Yellow eyes or skin, or dark urine. | A duct injury or a stone left in the duct. A rising bilirubin is never watched and waited on. |
The visit at seven to ten days exists mainly for one reason: the pathology report on the gallbladder is read by a doctor and explained to you.
| When | What is done |
|---|---|
| Seven to ten days. | The wounds are checked, and the report on the removed gallbladder is read, explained and filed. This happens for every patient, without exception. |
| If the report is a cholesterol polyp or adenomyomatosis. | You are discharged. No scans, no diet restriction, nothing further. |
| If the report is an adenoma, fully removed. | Explained, filed, and discharged. The growth has been taken out with the organ. |
| If the report shows a cancer. | Reviewed, the depth of invasion discussed, and a second larger operation considered within two weeks at a liver and bile duct unit where that depth calls for it. |
★★★★★
“Dr. Harsh Shah operated for a gall bladder tumour and the outcome was excellent. Very skilled surgeon, compassionate approach, and clear communication. Truly grateful. Highly recommended.”
— Sagar Parmar, Google review
★★★★★
“Dr. Harsh performed my wife’s gallbladder surgery and has been a thorough professional. He truly assuaged our concerns and treated us with great care. I have never met a surgeon who is consistently upbeat, and that makes a real difference to families whose loved ones are undergoing a surgical procedure.”
— Gaurav Roy, Google review
★★★★★
“Dr. Harsh Shah performed gallbladder surgery for my father, and our experience was excellent. He is very humble and highly knowledgeable. He patiently answered all our queries and took great care in explaining every detail. He was always supportive and addressed each of my father’s concerns with patience and clarity, which gave us a lot of confidence and comfort throughout the treatment. We are truly grateful for his care and would highly recommend him.”
— Sunny Shah, Google review
These are Google reviews, shown exactly as written. None of them is about a polyp being watched, so they speak to the gallbladder operation itself.
A gallbladder removal is covered by health insurance and the cashless panels. You get a written estimate before any admission.
What moves the estimate is the operation that is actually needed, the length of stay, and whether extra imaging came first. A day-care keyhole removal sits at one end. A planned radical operation for a suspected cancer, with a longer stay, sits at the other. The office at Apollo Hospital, Bhat prepares the pre-authorisation from the imaging, the reports and the surgical plan, and the figure is given to you in writing before you are admitted rather than afterwards. Please bring every scan on a disc or a link rather than only the printed report, your medicine list, your insurance card and an identity document.
Usually not. Most polyps seen on an ultrasound are cholesterol deposits or adenomyomatosis, and neither is a tumour. A true adenoma or an early cancer is uncommon. The point of the size-and-risk rules is to find that uncommon one.
It depends on more than the millimetre. A 7 mm polyp is removed if it is single and broadly based, if the wall beside it is thickened, if you are over sixty, if you have primary sclerosing cholangitis, if stones are present, or if the gallbladder is causing attacks. Without any of those, it is watched.
An ultrasound at six months, then at one year, then at two years. If the polyp has not changed by two years, the scans can stop. Any growth, any new worrying feature, or an attack of pain ends the watching early and the gallbladder is removed.
It carries some cancer risk, though far less than the figure taught for years. It is also an organ that is chronically diseased and usually full of stones, so removal is the usual advice. Watching is reasonable only for a frail patient with no symptoms, no lump and no weight loss.
Yes. Gallbladder cancer is common in north and east India, and South Asian background is written into the international guideline as a risk factor. So a polyp that would be watched elsewhere is more often removed here, particularly when coming back for scans is difficult.
Shah’s Gastro, Cancer & Robotic Surgery Centre — Gota, Ahmedabad
Consultations, reading the scan against the images, second opinions, the scan plan and follow-up.
Google: Dr Harsh Shah · 4.89 · 216 reviews
Directions to the Gota clinic · +91-63555-64601
Apollo Hospital — Bhat, Gandhinagar
Apollo Hospital International Limited, Plot No. 1 A, GIDC Bhat Industrial Estate, Bhat, Gandhinagar.
Ultrasound, endoscopic ultrasound, MRI, keyhole and open gallbladder surgery, pathology and inpatient care.
Google: Dr Harsh Shah – Robotic GI Surgeon · 4.94 · 18 reviews
Directions to Apollo, Bhat · WhatsApp +91-63555-64601
Patients come to Ahmedabad from across Gujarat, southern Rajasthan and western Madhya Pradesh. You can call us on +91-63555-64601.
Has an ultrasound or CT report used the words polyp, polypoid lesion, adenomyomatosis or a calcified gallbladder wall? The scan images themselves, not only the typed report, along with any earlier scan for comparison and your liver function tests, can be sent ahead so the consultation starts with them already read. What is done is decided at the consultation, after examination. Call +91-63555-64601 · Send the scan ahead on WhatsApp
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