ROJoson PEP Talk: Asymptomatic Gallbladder Polyps among Seafarer - To Operate or Not

1. January 13, 2024
1400H - 1500H
Via Zoom
ASYMPTOMATIC
GALLBLADDER
POLYPS AMONG
SEAFARERS – TO
OPERATE OR NOT
Empowerment
objective - for laypeople
specially the seafarers
to have an essential
understanding on the
management of
ASYMPTOMATIC
GALLBLADDER POLYPS
among SEAFARERS as
part of their health
management.

2. January 13, 2024
1400H - 1500H
Via Zoom
ASYMPTOMATIC
GALLBLADDER
POLYPS AMONG
SEAFARERS – TO
OPERATE OR NOT
Empowerment
objective - for laypeople
specially the seafarers
to have an essential
understanding on the
management of
ASYMPTOMATIC
GALLBLADDER POLYPS
among SEAFARERS as
part of their health
management.
Welcome all!
MUTE yourself but always
show your video picture.
Sign in your name, FB
account, or email address in
the Chat Box! Include names
of companions attending.
Use the Chat Box to ask
questions and make
comments while the PEP TALK
is on.
There will be group pictures
at start and end of PEP TALK –
show your face in video.

3. Reminder after the PEP
Talk:
Take the Online Learning
cum Evaluation Test
Exercise (OLETE) for
mastery of learning and
have a perfect score to get
a Certificate.
Link is in Chat Box.

4. Reminder:
50 OLETE Certificates = 1
Voucher for ROJoson
Medical Consultation
either Face-to-Face or
Telemedical.

5. ASYMPTOMATIC
GALLBLADDER
POLYPS AMONG
SEAFARERS – TO
OPERATE OR NOT
Empowerment
objective - for laypeople
specially the seafarers
to have an essential
understanding on the
management of
ASYMPTOMATIC
GALLBLADDER POLYPS
among SEAFARERS as
part of their health
management.
ROJOSON’S REQUEST:
FEEDBACK TO THIS
PEP TALK!
Pls. type in your
feedback in the chat
box during the open
forum and before we
adjourn!
Thank you!

6. ASYMPTOMATIC
GALLBLADDER
POLYPS AMONG
SEAFARERS – TO
OPERATE OR NOT
Empowerment
objective - for laypeople
specially the seafarers
to have an essential
understanding on the
management of
ASYMPTOMATIC
GALLBLADDER POLYPS
among SEAFARERS as
part of their health
management.
LET’S NOW HAVE A
GROUP PICTURE
TAKING BEFORE WE
START PEP TALK
PROPER IN 2
MINUTES!
Pls. turn on your
video!
Show your face!

7. ASYMPTOMATIC
GALLBLADDER
POLYPS AMONG
SEAFARERS – TO
OPERATE OR NOT
Empowerment
objective - for laypeople
specially the seafarers
to have an essential
understanding on the
management of
ASYMPTOMATIC
GALLBLADDER POLYPS
among SEAFARERS as
part of their health
management.
ROJoson PEP Talk
I have a Patient
Empowerment
Program in which I
like to empower the
lay people or
patients to take
control in the
management of
their health.

8. I started the PEP Talk
on May 15, 2021
during the COVID19
Pandemic. There are
3 courses in the PEP
Talk. I completed the
Core Course on
October 9, 2021.

9. From October 23,
2021 onwards, I have
been tackling Health
Disorder and Health
Issue Courses. This
may take 3 years or
longer depending on
our enthusiasm,
discipline and
perseverance.

10. ASYMPTOMATIC
GALLBLADDER
POLYPS AMONG
SEAFARERS – TO
OPERATE OR NOT
Empowerment
objective - for laypeople
specially the seafarers
to have an essential
understanding on the
management of
ASYMPTOMATIC
GALLBLADDER POLYPS
among SEAFARERS as
part of their health
management.
My PEP TALK today is
entitled:
ASYMPTOMATIC
GALLBLADDER
POLYPS AMONG
SEAFARERS – TO
OPERATE OR NOT

11. Contents
• What is the gallbladder?
• What are the usual gallbladder disorders or diseases?
• What is / are gallbladder polyps? How do gallbladder
polyps differ from gallbladder stones?
• What are asymptomatic and symptomatic gallbladder
polyps?
• How to manage / treat asymptomatic gallbladder
polyps?
• Why is asymptomatic gallbladder polyp / polyps
important in seafarer’s health and occupation?
• What are the common challenges on asymptomatic
gallbladder polyps faced by prospective seafarers?
• What are the services that ROJoson can offer for
seafarers with asymptomatic gallbladder polyps?
Disclaimer:
ROJoson PEP Talk
contains ROJoson’s
Thoughts,
Perceptions,
Opinions and
Recommendations
(TPORs) culled from
experiences of
ROJoson and other
professionals.
ASYMPTOMATIC
GALLBLADDER
POLYPS AMONG
SEAFARERS – TO
OPERATE OR NOT

12. What is the gallbladder?
The Tagalog term, as far as I
know, is “abdo.”
Where is the gallbladder
located?
The gallbladder is a small, pear-
shaped organ on the right side of
the abdomen, just beneath the
liver.
ASYMPTOMATIC
GALLBLADDER
POLYPS AMONG
SEAFARERS – TO
OPERATE OR NOT

13. What is the gallbladder?
The gallbladder holds a digestive fluid called BILE that comes from the
liver and is released into the small intestine to aid in digestion, especially
fats.
ASYMPTOMATIC
GALLBLADDER
POLYPS AMONG
SEAFARERS – TO
OPERATE OR NOT

14. What are the usual gallbladder disorders or
diseases?
- Cholecystitis (infection of the gallbladder)
- Gallbladder polyps
- Gallbladder stones
- Gallbladder cancer
ASYMPTOMATIC
GALLBLADDER
POLYPS AMONG
SEAFARERS – TO
OPERATE OR NOT

15. What are the usual gallbladder disorders or
diseases?
- Cholecystitis (inflammation /infection of the
gallbladder) – with or without stones
ASYMPTOMATIC
GALLBLADDER
POLYPS AMONG
SEAFARERS – TO
OPERATE OR NOT

16. What are the usual gallbladder disorders or
diseases?
- Gallbladder polyps
ASYMPTOMATIC
GALLBLADDER
POLYPS AMONG
SEAFARERS – TO
OPERATE OR NOT

17. What are the usual gallbladder disorders or
diseases?
- Gallbladder polyps
ASYMPTOMATIC
GALLBLADDER
POLYPS AMONG
SEAFARERS – TO
OPERATE OR NOT

18. What are the usual gallbladder disorders or
diseases?
- Gallbladder stones
ASYMPTOMATIC
GALLBLADDER
POLYPS AMONG
SEAFARERS – TO
OPERATE OR NOT

19. What are the usual gallbladder disorders or
diseases?
- Gallbladder cancer
ASYMPTOMATIC
GALLBLADDER
POLYPS AMONG
SEAFARERS – TO
OPERATE OR NOT

20. What is / are gallbladder polyps?
An elevation or outgrowth of the gallbladder
mucosa or wall that protrudes into the
gallbladder lumen.
ASYMPTOMATIC
GALLBLADDER
POLYPS AMONG
SEAFARERS – TO
OPERATE OR NOT

21. What is / are gallbladder polyps?
The exact cause is not known. Some may be due
to inflammatory reaction. Some may be due to
high cholesterol.
ASYMPTOMATIC
GALLBLADDER
POLYPS AMONG
SEAFARERS – TO
OPERATE OR NOT

22. How does gallbladder polyps differ from gallbladder
stones?
ASYMPTOMATIC
GALLBLADDER
POLYPS AMONG
SEAFARERS – TO
OPERATE OR NOT

23. How does gallbladder polyps differ from gallbladder
stones?
ASYMPTOMATIC
GALLBLADDER
POLYPS AMONG
SEAFARERS – TO
OPERATE OR NOT

24. What are asymptomatic and symptomatic
gallbladder polyps?
Asymptomatic gallbladder polyps – those without
symptoms – no abdominal pain
Symptomatic gallbladder polyps – those with
symptoms especially abdominal pain
ASYMPTOMATIC
GALLBLADDER
POLYPS AMONG
SEAFARERS – TO
OPERATE OR NOT
Asymptomatic
gallbladder polyps
are usually
discovered
incidentally or
accidentally through
ultrasound of the
abdomen.

25. How to manage / treat asymptomatic gallbladder polyps?
Asymptomatic gallbladder polyps less than 1 cm in size is
usually managed with a wait and see or watchful waiting
approach (meaning no operation; just monitoring with
ultrasound at planned intervals; no medications;
improvement of lifestyle into a healthy one – healthy diet
and exercise).
Operation is indicated if the polyps is 1 cm in size or bigger
even if asymptomatic. [because of the risk for gallbladder
cancer.]
NOTE: Operation is indicated if the polyps is less than 1 cm
and patient is symptomatic.
ASYMPTOMATIC
GALLBLADDER
POLYPS AMONG
SEAFARERS – TO
OPERATE OR NOT

26. What are the recent guidelines in ultrasound monitoring of gallbladder
polyps?
In the low risk category, no follow-up is recommended for polyps of 6
mm or smaller;
follow-up US at 12 months is recommended for polyps measuring 7–9
mm;
follow-up US at 6, 12, 24, and 36 months is recommended for polyps
measuring 10–14 mm; and
surgical consultation is recommended for polyps of 15 mm or larger.
Management of Incidentally Detected Gallbladder Polyps: Society of Radiologists in Ultrasound
Consensus Conference Recommendations
https://doi.org/10.1148/radiol.213079
ASYMPTOMATIC
GALLBLADDER
POLYPS AMONG
SEAFARERS – TO
OPERATE OR NOT

27. Why is asymptomatic gallbladder polyp / polyps important in seafarer’s health and
occupation?
Nowadays, part of the routine medical examination for the seafarers includes ultrasound
of the abdomen.
Ultrasound can easily detect gallbladder polyps even if a seafarer is asymptomatic and
gallbladder polyps is commonly detected on ultrasound even if a seafarer is
asymptomatic.
With the detection of gallbladder polyps on ultrasound of the abdomen, a decision has
to be made by the manning agencies – to operate or not to operate. Most of the times,
physicians of the manning agencies would recommend surgical removal even though
watchful waiting can be done.
- A BIG CHALLENGE FOR THE SEAFARERS WITH ASYMPTOMATIC GALLBLADDER POLYPS.
ASYMPTOMATIC
GALLBLADDER
POLYPS AMONG
SEAFARERS – TO
OPERATE OR NOT

28. What are the common challenges on
asymptomatic gallbladder polyps faced by
prospective seafarers?
The biggest challenge is whether to undergo
operation for removal of the gallbladder
polyps as required by the physicians of the
manning agencies, knowing that
asymptomatic gallbladder polyps less than 1
cm can be treated just by watchful waiting
(observation).
If the physicians of the manning agencies
would respect a recommendation from a
surgeon that there is NO need for operation,
then NO problem.
ASYMPTOMATIC
GALLBLADDER
POLYPS AMONG
SEAFARERS – TO
OPERATE OR NOT
Options in case operation is required
by the physicians of the manning
agencies:
- Proceed with operation so that one
can be deployed as soon as
possible.
- Look for another manning agency
where their physicians do not
require operation as long as there is
a recommendation (medical
clearance) by a surgeon on no need
for operation.
- Look for another non-seafarer job.

29. What are the services that ROJoson can offer for seafarers with
asymptomatic gallbladder polyps?
- Patient Empowerment Talk – to enlighten laypeople particularly the
seafarers on gallbladder polyps, especially on the options of
management
- Give a medical clearance for deployment in asymptomatic gallbladder
polyps less than 1 cm (with the caveat that the final decision rests on
the physicians of the manning agencies)
- Do the operation (but only open cholecystectomy) at a compassionate
fee.
- Assist seafarers in looking for a hospital which can offer operations at a
low cost.
ASYMPTOMATIC
GALLBLADDER
POLYPS AMONG
SEAFARERS – TO
OPERATE OR NOT

30. ASYMPTOMATIC
GALLBLADDER
POLYPS AMONG
SEAFARERS – TO
OPERATE OR NOT
Summary
Take Away
Contents
• What is the gallbladder?
• What are the usual gallbladder disorders or diseases?
• What is / are gallbladder polyps? How do gallbladder
polyps differ from gallbladder stones?
• What are asymptomatic and symptomatic gallbladder
polyps?
• How to manage / treat asymptomatic gallbladder
polyps?
• Why is asymptomatic gallbladder polyp / polyps
important in seafarer’s health and occupation?
• What are the common challenges on asymptomatic
gallbladder polyps faced by prospective seafarers?
• What are the services that ROJoson can offer for
seafarers with asymptomatic gallbladder polyps?

31. ASYMPTOMATIC
GALLBLADDER
POLYPS AMONG
SEAFARERS – TO
OPERATE OR NOT
Take Away in
relation to
Patient
Empowerment
Be always in touch with reliable medical
information on ASYMPTOMATIC GALLBLADDER
POLYPS AMONG SEAFARERS.
Knowledge is power; it gives power.
Use the 4Ks of Patient Empowerment:
Kaalaman, Kakayanan, Karapatan and
Kapangyarihan to gain greater control over
decisions / make better decisions on
management of ASYMPTOMATIC
GALLBLADDER POLYPS among SEAFARERS
as part of your health management.

32. ASYMPTOMATIC
GALLBLADDER
POLYPS AMONG
SEAFARERS – TO
OPERATE OR NOT
Empowerment
objective - for laypeople
specially the seafarers
to have an essential
understanding on the
management of
ASYMPTOMATIC
GALLBLADDER POLYPS
among SEAFARERS as
part of their health
management.

33. Reminder after the PEP
Talk:
Take the Online Learning
cum Evaluation Test
Exercise (OLETE) for
mastery of learning and
have a perfect score to get
a Certificate.
Link is in Chat Box.

34. Reminder:
50 OLETE Certificates = 1
Voucher for ROJoson
Medical Consultation
either Face-to-Face or
Telemedical.

35. ASYMPTOMATIC
GALLBLADDER
POLYPS AMONG
SEAFARERS – TO
OPERATE OR NOT
Empowerment
objective - for laypeople
specially the seafarers
to have an essential
understanding on the
management of
ASYMPTOMATIC
GALLBLADDER POLYPS
among SEAFARERS as
part of their health
management.
ROJOSON’S REQUEST:
FEEDBACK TO THIS
PEP TALK!
Pls. type in your
feedback in the chat
box during the open
forum and before we
adjourn!
Thank you!

36. ASYMPTOMATIC
GALLBLADDER
POLYPS AMONG
SEAFARERS – TO
OPERATE OR NOT
Empowerment
objective - for laypeople
specially the seafarers
to have an essential
understanding on the
management of
ASYMPTOMATIC
GALLBLADDER POLYPS
among SEAFARERS as
part of their health
management.
LET’S NOW HAVE A
GROUP PICTURE
TAKING BEFORE WE
START Q&A AND
INTERACTIONS!
Pls. turn on your
video!
Show your face!