Last month the unit physical examination, Ms. Zhang ultrasound found a long thing in the gallbladder, from the ultrasound to see the long thing in the gallbladder cavity does not move, is long in the wall of the gallbladder. Physical examination report: gallbladder occupying lesion, gallbladder polyp? Further outpatient examination at the hospital is recommended. Ms. Zhang is usually in good health, and if it were not for the discovery of gallbladder polyps she would not have felt any discomfort at all. When she heard that she had polyps, she was very nervous, and in the past few days she did not eat well or sleep well. Mr. Li found gallbladder polyps almost 10 years ago, just found that years have been closely reviewed, polyps from 0.3 cm slowly grew to 0.5 cm, due to no discomfort and the last 3 years of work is busy, has not been reviewed. In the last 2 months, Mr. Li felt uncomfortable in the right upper abdomen, and went to the hospital for ultrasound and found that the polyp had grown to 1.2 cm at some point. Most of the gallbladder polyps are found in the occasional ultrasound physical examination, and about 5% of the people in the physical examination organized by the unit are found to have gallbladder polyps. How do you get gallbladder polyps? In the end, whether to treat …… we will be on these issues of concern to everyone to answer in detail. 1, how are the symptoms of gallbladder polyps? Gallbladder polyps are generally mild or even asymptomatic. A few patients have epigastric discomfort, which may be accompanied by abdominal pain, discomfort or pain in the right upper abdomen or right quarter of the ribs, and a few may be accompanied by radiation to the back of the right shoulder. Polyps located in the neck of the gallbladder can appear biliary colic, in combination with stones can have biliary colic attacks and acute and chronic inflammatory attacks. 2.Why do we get gallbladder polyps? In recent years, the detection rate of gallbladder polyps has increased, and it has become a common disease. The reason for this is due to the increase in the popularity of medical checkups on the one hand, and on the other hand, it may be related to the changes in the diet structure and dietary rules of Chinese people and unknown factors such as the living environment, which include high cholesterol diets, long-term alcohol abuse, excessive consumption of stimulating diets, and disorders in dietary rules, etc. It has also been pointed out that there is a relationship between the widespread use of pesticides and chemical fertilizers, the widespread use of food additives, and the formation of ionizing radiation and the formation of gallbladder polyps. The following are some of the reasons for this. 3 Are gallbladder polyps necessarily malignant? In fact, gallbladder polyps or gallbladder polyposis is a generalized term, a few polyps and gallbladder cancer are still related. There are the following clinical conditions: First: cholesterol polyps: about 65%, also known as pseudo-polyps. It is currently theorized that such polyps are not cancerous. It has a mulberry-like appearance, brittle and fragile, the tip is as thin as cotton thread, very easy to fall off, mostly within 10 millimeters, mainly hair, mostly located in the body of the gallbladder. Most patients with cholesterol polyps are asymptomatic or have mild symptoms and good gallbladder function. Cholesterol polyps are related to diet, and patients with a high cholesterol diet or fatty liver are prone to cholesterol polyps. Recommendations for patients with cholesterol polyps: no alcohol, regular diet, breakfast, low cholesterol diet. Excessive cholesterol intake (egg yolks, fatty meats, scaly fish, animal offal, etc.) can aggravate the metabolism of the liver and gallbladder causing excess cholesterol to crystallize, accumulate and precipitate in the wall of the gallbladder, thus forming cholesterol polyps. If these polyps are smaller than 0.5 centimeters and are few in number, medication can be tried. For cholesterol polyps that are less than 1 centimeter, you can have regular ultrasound checkups every 6 months to a year to observe changes in size, shape, and number. The second type: non-cholesterol benign polyps: about 30%, also known as true polyps. Mainly refers to: gallbladder adenoma, adenomyoma, inflammatory polyps, adenomatous hyperplasia. Inflammatory polyps are formed when chronic cholecystitis is combined with long-term gallbladder stone stimulation. Adenoma of gallbladder is a benign tumor, which is a precancerous lesion with a cancer rate of about 30%. Adenomyosis and adenomatous hyperplasia also have cancer risk. This type of patients with drug treatment is ineffective, bile preservation and drug treatment is not recommended, cholecystectomy is recommended. The third type: polyp-type early gallbladder adenocarcinoma: about 5%, in fact, this type is not strictly speaking the category of gallbladder polyps. At present, for polyp-type early gallbladder cancer mixed in gallbladder polyps, sometimes it is difficult to identify by ultrasound alone, and if necessary, thin-layer enhanced CT or MRI enhancement scan should be done. The ultrasound characteristics of cancerous polyps are: more than 80% of them are larger than 10 millimeters and solitary; about 70% of them are located in the neck of gallbladder; about half of them are accompanied by gallbladder stones. Once suspected of such lesions should be early surgical treatment. 4.Can I take medicine to treat gallbladder polyps? For multiple cholesterol polyps, some medications may relieve the symptoms of chronic cholecystitis to some extent, and may have some effect on cholesterol crystals less than 5mm or prevent new ones. Drugs are not effective for true polyps. 5. How can I be examined and rechecked for gallbladder polyps? In most cases, B-ultrasound can determine whether there are stones or polyps in the gallbladder at an early stage, and is even more sensitive than CT and MRI in terms of number, shape and size. However, to further define the type and nature of polyps, especially the latter two types mentioned above, a thin layer enhanced CT or MRI enhanced scan may be needed to help with the diagnosis. Admittedly, there are times when these tests are not 100% definitive and require the doctor’s comprehensive judgment of the patient’s condition. The nature of some polyps can not be determined, and even need to review the ultrasound once every three months, close observation. 6.Does gallbladder removal affect my health? The age of cholecystectomy patients ranges from teenagers to 80 years old, and cholecystectomy has become a common abdominal surgery. Some people have mild diarrhea and bloating in the short term after cholecystectomy, especially after eating a lot of greasy, high-fat food. This phenomenon can be gradually compensated for the missing function of the gallbladder by liver secretion and dilation of the common bile duct, and most of the diarrhea and bloating can be diminished or disappeared a few months after the surgery. At present, there is no clear evidence of evidence-based medicine to prove that the removal of the gallbladder can cause other diseases in the human body, and the current level of medical science believes that the removal of the gallbladder will not have a major impact on the human body. 7.What kind of gallbladder polyps should be operated? Gallbladder polyps is a common disease, neither too worried nor careless. Now everyone’s health awareness has increased, unit or individual physical examination found that the gallbladder polyps, feel that a lot of polyps must be bad, unavoidably afraid of tension. From clinical experience, generally speaking, the polyp may be better than a single polyp, polyp most of the benign cholesterol polyp; and if it is a single on the contrary to a high degree of vigilance. If the polyp is smaller than 1 cm, the patient is advised to observe it, but not to leave it alone. Ultrasound should be done about half a year, and during the observation period, it is most important to improve the living habits and dietary structure. If there are uncomfortable symptoms, you can try to take some medication to relieve the symptoms. It is generally believed that multiple gallbladder polyps with a diameter of less than 1 cm can be treated without surgery for the time being. Surgery for gallbladder polyps has two considerations, one is to prevent cancer or missed diagnosis of cancer, which mainly refers to the latter two types of polyps mentioned earlier. On the other hand, it is for the symptoms, if the uncomfortable symptoms are not relieved by medication, secondary chronic cholecystitis affecting normal work and life, and can be excepted gastric disease and other factors can be considered cholecystectomy. In short: polyps that grow rapidly over a short period of time; single or multiple polyps larger than 1 cm; wide basal gallbladder polyps; accompanied by localized or total thickening of the gallbladder wall; combined with gallbladder stones and chronic cholecystitis; and ultrasound, CT, and MRI do not exclude the possibility of carcinoma, surgery is usually recommended. More than two decades ago, gallbladder removal required a large incision in the abdomen, but now 99% can be done laparoscopically, and the surgeon can complete laparoscopic cholecystectomy under the monitor, resulting in less trauma to the patient, quicker recovery, and more beautiful wounds after surgery.