I often meet patients with gallbladder polyps in specialist clinics, who are very nervous and tell me that the local doctor says that they have to operate immediately, otherwise they are prone to cancer. In fact, it is necessary to have some understanding of the disease to reduce unnecessary fears as well as improper medical treatment. Polypoid lesions of the gallbladder are also known as gallbladder augmentation lesions. (A) Etiology and pathology With the diversification of human diet, diet structure and the further aggravation of environmental pollution. The incidence of gallbladder polyps is increasing year by year. The etiology is generally unclear, and is related to high cholesterol diet, long-term alcohol abuse, excessive intake of stimulating diet, irregular diet such as: no good breakfast or no breakfast, too much dinner, etc. Most of them are non-neoplastic polyps, including cholesterol polyps, inflammatory polyps and adenomyeloid hyperplasia of the gallbladder. Few of them are tumor polyps. 1, cholesterol polyps, also known as cholesterol deposits in the gallbladder, are cholesterol crystalline polyps formed by the precipitation of bile salt crystals in the bile after prolonged retention of bile in the gallbladder. Deposited in the gallbladder wall to the gallbladder mucosal epithelial cells basement membrane gathered a large number of phagocytes, in the mucosa to form multiple nodules to the gallbladder cavity, shaped like a strawberry, so also strawberry-like gallbladder. They account for about 90% of gallbladder polyps. Most of them develop into gallbladder stones. 2, inflammatory polyps are inflammatory granulomatous changes of gallbladder mucosa caused by chronic inflammatory stimulation. It is characterized by lymphocyte and monocyte-dominated inflammatory cell infiltration within the papillae, abundant small blood vessel proliferation, and scarred fibrous tissue. 3, adenomyeloid hyperplasia of the gallbladder The gallbladder mucosa is accompanied by epithelial cell hyperplasia with mucinous glandular metaplasia, forming adenoma-like elevations, mostly seen in the bottom body of the gallbladder, single or multiple, with smooth surface and usually without a tip. Histologically, smooth muscle fibers connected to the muscular layer in the fibrous interstitium are visible, and cupped cells are visible. 4, Gallbladder adenomas are divided into simple adenomas and papillary adenomas, mostly solitary, with short tissues, smooth surface or lobulated, simple adenomas consist of dense glandular vesicles with little interstitial nodal tissue. Papillary adenomas are branched, with cuboidal or columnar epithelial cells on their surface, with abundant nodular tissue scaffolding and scattered mostly cystic glands. (B) Clinical manifestations and diagnosis Most of them have no clinical symptoms and are only detected during ultrasound examination. Some patients have vague pain and discomfort in the right upper abdomen, gastrointestinal symptoms such as aversion to grease and nausea. If combined with stones or large polyps located in the cervical duct of gallbladder and interstitially obstructing the cystic duct, acute cholecystitis manifestations such as biliary colic, fever and pressure pain in the right upper abdomen may occur. The diagnosis is mainly based on ultrasound examination. Multiple small polyps are mostly cholesterol polyps; round elevated polyps with diameter less than 1cm may be inflammatory polyps or adenomas; masses with diameter greater than 1cm and uneven echogenicity without a tip should be considered as adenomatous polyps with malignant transformation or gallbladder cancer. (C) Treatment For asymptomatic small gallbladder polyps or symptomatic gallbladder polyps, multiple, less than 1cm in diameter, mostly cholesterol crystalline polyps. Dietary therapy can be used, insist on eating breakfast with eggs at every meal (not easy for those who have biliary colic symptoms after meals), or medication, anti-inflammatory and biliary drugs and litholytic drugs, such as goose (bear) deoxycholic acid tablets to reduce the retention of bile in the gallbladder or change the composition of bile, increase the emptying of the gallbladder, prevent the precipitation of cholesterol crystals, promote the discharge of bile, and even cholesterol crystalline polyps from the gallbladder . Ultrasound will be reviewed every 3-6 months for follow-up observation. If the above methods are ineffective or the diameter is greater than 1 cm, theoretically, there is a greater chance of malignant transformation, so surgery is recommended, and we mostly use laparoscopic cholecystectomy, which is characterized by less damage, less pain and recovery blocks. It is worth recommending.