Recommendations for the diagnosis and treatment of polypoid lesions of the gallbladder

  With the widespread development and popularization of ultrasound and other imaging technologies in clinical practice, the term “gallbladder polyp-like lesions” appears frequently in people’s examination reports; moreover, once a considerable number of people see the words “gallbladder polyp-like lesions”, they will associate the word “lesions” with Once they see the word “lesion”, they will associate the word “lesion” directly with “cancer”, which makes them panic. In fact, this is not the case with gallbladder polyp-like lesions.  Gallbladder polyp-like lesions are medical morphological descriptions, which generally refer to the lesions of the gallbladder wall protruding into the cystic cavity, and their morphological manifestations are limited elevations, which can be single or multiple, divided into neoplastic and non-neoplastic lesions: non-neoplastic lesions include cholesterol polyps, inflammatory polyps, gallbladder adenomyosis, etc., and neoplastic lesions include adenoma and smooth muscle tumor, etc. At present, the detection rate of gallbladder polyp-like lesions is gradually increasing, and the detection rate is about 5%-7% in adults who receive abdominal ultrasound examination. Most of the gallbladder polyp-like lesions found on physical examination or by chance are mostly benign lesions, and very few of them are precancerous or malignant lesions.  At present, the reasons for the formation of gallbladder polyp-like lesions are still not very clear and may be related to the following factors: gallbladder dysfunction, chronic inflammation, high-fat diet, skipping breakfast, smoking, chronic hepatitis, etc.  Clinically, most patients with gallbladder polypoid lesions are asymptomatic, and a few patients have no conscious symptoms, usually found incidentally during ultrasonography; a few of them may present with right upper abdominal discomfort, abdominal distension, and vague pain. The diagnosis of gallbladder polypoid lesions depends mainly on imaging, mainly ultrasonography, but can also be detected during CT and MRI examinations.  For the treatment of gallbladder polypoid lesions, the focus is on differentiating benign from malignant, but there is still no very clear examination means and diagnostic basis for the classification of benign and malignant. At present, the national expert consensus in this field is that the majority of gallbladder polyp-like lesions are benign, and most of them can be treated conservatively (no treatment, or symptomatic treatment with choleretic and anti-inflammatory drugs), and require regular ultrasound examination (once every 3-6 months). In a small number of patients, surgery (laparoscopic cholecystectomy) should be considered in the following cases: polyp lesions larger than 10 mm in diameter; broad-based solitary lesions; polyps with a tendency to increase in size in a short period of time; gallbladder polyps combined with gallbladder stones.  Therefore, for patients diagnosed with gallbladder polyp-like lesions, there is no need to worry too much. If there are any of the above special cases, you can go to the hospital and consult the experts to avoid delaying the disease.