Gallbladder polyp is a general term for a type of lesion in which the wall of the gallbladder bulges into the lumen in a polyp-like manner, also known as “gallbladder augmentation lesion”. Clinically, gallbladder polyps include mucosal polyp-like hyperplasia caused by inflammation of gallbladder, polyp-like changes caused by degeneration of gallbladder mucosal cells, adenomatous polyps of gallbladder and polyp-like gallbladder cancer. There are benign polyps and malignant polyps in the pathology of gallbladder polyps. Benign gallbladder polyps are divided into two categories: benign neoplastic polyps and pseudotumor polyps, among which benign neoplastic polyps can originate from epithelial tissue (adenoma) and supporting tissue (hemangioma, lipoma, etc.), while pseudotumor polyps include cholesterol polyps, inflammatory polyps, adenomyomatosis of gallbladder, and tissue ectopic polyps. Adenomatous polyps of the gallbladder are potentially precancerous lesions and are associated with the development of gallbladder cancer. In contrast, pseudotumoral polyps such as cholesterol polyps, inflammatory polyps and adenomyosis of the gallbladder are not carcinogenic. Clinical manifestations Clinical symptoms associated with gallbladder polyps include abdominal pain, paroxysmal vomiting, abdominal distention, and intolerance of fatty foods. However, some patients have no clinical symptoms and the lesions are detected only during ultrasound examination. In contrast, most patients mainly present with intermittent right upper abdominal discomfort with or without right shoulder back discharge pain, and individual cases with biliary colic. Examination B ultrasound, CT, cholecystography, etc. Diagnosis Diagnosis mainly relies on imaging examinations, including ultrasound, CT, cholecystography, etc. Treatment Mainly involves the determination of benign and malignant gallbladder polyps, so as to achieve early detection of malignant lesions and precancerous lesions and early surgical removal. 1, gallbladder polyp malignant risk factors and surgical indications (1) the size of gallbladder polyps most scholars have concluded that the size of gallbladder polyps and their benignity and malignancy are related. Small gallbladder polyps (<10mm in diameter) have been found to be mostly benign lesions and can remain unchanged for many years. For large gallbladder polyps, malignant lesions are indicated. (2) Age is significantly greater in patients with gallbladder polyps than in patients with non-neoplastic polyps in terms of mean age and diameter of gallbladder adenomas and gallbladder cancers. (3) The number and morphology of polyps single, broad-based polyps are prone to carcinogenesis. The malignant tendency of gallbladder polyps occurs in older, solitary, and large gallbladder polyps. (4) Combined gallbladder stones The relationship between gallbladder cancer and gallbladder stones has been relatively clear, and some gallbladder cancer patients can be combined with gallbladder stones at the same time. Therefore, the presence of stones increases the risk of gallbladder carcinogenesis. (5) Accompanying clinical symptoms Malignant gallbladder polyps are more inclined to accompanying clinical symptoms. Combining the above risk factors for malignant gallbladder polyps, for young patients with gallbladder polyps, if the polyps are small in diameter (10 mm as the boundary) and completely asymptomatic, surgery is not necessary; for young patients with gallbladder polyps, if the polyps are small in diameter and only have dyspeptic symptoms (abdominal distension, belching, etc.), they can be treated conservatively. For patients with obvious biliary colic, especially with gallstones, cholecystectomy should be performed; for patients with polyps >10mm in diameter and risk factors for gallbladder polyp malignancy, early cholecystectomy should be performed. For patients with polyps <10mm in diameter and without risk factors of gallbladder polyp malignancy, they can be observed and ultrasound investigation can be performed regularly. 2.Surgical treatment For patients with polyps less than 10mm in diameter, multiple polyps with tips, suggesting the possibility of pseudotumor polyps, laparoscopic cholecystectomy is preferred. For patients with polyps >10 mm in diameter and risk factors for malignant gallbladder polyps, they are suggested to be neoplastic polyps and should undergo routine open cholecystectomy. Intraoperative frozen sections are routinely performed to clarify the pathological category. In case of cancerous polyps, simple cholecystectomy is feasible when the tumor is limited to the mucosa; once the tumor invades the muscular layer, an extended resection including wedge resection of the liver in the gallbladder bed and lymph node dissection is required. Although there is a lot of controversy in the surgical management of gallbladder polyp-like lesions, in general, gallbladder polyps >10 mm in diameter, age >50 years, solitary, broad-based and combined with gallbladder stones have been considered as risk factors for gallbladder polyp malignancy. Selection of patients suitable for surgery can be based on these risk factors. For gallbladder polyps <10 mm in diameter and without clinical symptoms, ultrasound exploration can be performed periodically, and if abnormalities are detected, prophylactic surgical resection is performed.