Gallbladder polyp:It is the abbreviation of various benign bulges of the gallbladder mucosa. The symptoms of most gallbladder polyps are similar to those of chronic cholecystitis, mainly manifesting as mild discomfort in the right upper abdomen and biliary colic in the presence of stones. However, a significant number of people are asymptomatic and are only detected during health examinations, which often causes delays. Currently, the main treatment for gallbladder polyps in Western medicine is surgery. However, surgical treatment is associated with complications such as vascular damage and organ damage, either of which can lead to serious consequences. In addition, it is a treatment for the symptoms rather than the root cause, because surgery only targets the lesion, but not the causative factors, so it cannot solve the problem at the root.
Treatment mechanism of gallbladder polyps
1.Correct the formation of polyps bile, stop the growth and regeneration of polyps.
2.Change the local microenvironment of the lesion, cut off the nutrient supply of the polyp, make the tumor dry up from the root, atrophy and necrosis ” tumor dead and fallen “, through the body cavity with the body excreted.
3.Active ingredients attached to the surface of the tumor, soaked into the polyp tissue body directly kill cells, so that they are inactivated and not allowed to revive. Transform the decay and regenerate the muscle, repair the basal tissue and restore the function of stomach and intestine.
4.Comprehensively adjust the immune function of human body and correct the imbalance of the organism. Cure gallbladder polyps.
The treatment starts from adjusting and reversing the overall pathological factors of patients and balancing yin and yang, which can gradually shrink and absorb the gallbladder polyps and eventually disappear completely, so as to achieve the purpose of complete recovery. Clinical observation by tens of thousands of cases has shown remarkable efficacy, which can be cured in 1-3 months in general.
Clinical manifestations
The symptoms of most gallbladder polyps are similar to those of chronic cholecystitis, mainly manifesting as mild discomfort in the right upper abdomen and biliary colic when accompanied by stones, but there are a considerable number of patients who are asymptomatic and are only discovered when doing health checkups. It is generally believed that gallbladder polyp is a predisposing factor for gallbladder cancer. In recent years, there are many reports about gallbladder polyp carcinogenesis at home and abroad, especially when accompanied with stones, the chance of carcinogenesis will be significantly increased.
Clinically, gallbladder polyps can be divided into three periods, namely: active growth period, relative stability period, absorption and dissipation period.
Active growth period Relative stability period Absorption and dissipation period
Volume of gallbladder polyps increasing, not changing, gradually decreasing
Number of gallbladder polyps Increasing, unchanging, gradually decreasing
Clinical features
Feature 1: Increasing incidence
With the diversification of human diet structure and diet rhythm and the intensification of environmental pollution, the incidence of gallbladder polyps gradually increases, such as: high cholesterol diet, long-term alcohol abuse, excessive consumption of stimulating diet, disorders of dietary patterns such as: not eating good breakfast or breakfast, too much dinner, too much and other bad eating habits, too many pesticides, food additives, ionizing radiation filled space, etc. are all directly and indirectly related to the formation of gallbladder polyps. There is a direct and indirect relationship between the formation of gallbladder polyps, thus breeding the first characteristic of gallbladder polyps – the incidence of gradually increasing.
Feature 2: Hidden aggressiveness
Gallbladder polyps are mostly asymptomatic, and more than 85% of patients are found during routine physical examinations. On examination, polyps below 3-4 mm are difficult to detect or often missed on CT and MRI. Asymptomatic gallbladder polyps give the false impression of being painless and disease-free.
With the development of imaging, the detection rate of gallbladder polyp disease gradually increases, while doctors in non-specialized hospitals do not know or recognize this disease or do not pay attention to it, thus creating a blind spot in the diagnosis and cognition of gallbladder polyps and the vacuum zone of diagnosis and treatment, forming a wide hidden space for gallbladder polyps.
Feature 3: High cancer rate
The lethal power of gallbladder polyps lies in the sudden cancerous transformation. From the 1980s to 1990s, the cancer rate gradually increased due to the different nature of the formed gallbladder polyps. And during or after the cancerous transformation, many patients with gallbladder polyps do not feel discomfort and develop unknowingly and become cancerous unknowingly, which is the most frightening feature of gallbladder polyps.
Treatment and prevention
Gallbladder polyp lesions are not uncommon clinically, and surgery is the radical cure, but not all gallbladder polyps require surgical treatment. Because of the different types of lesions, different sizes and different disease regression, the indications for surgery are not consistent.
Timing of surgery: Gallbladder polyp-like lesions are sometimes difficult to characterize preoperatively. We propose the following surgical indications according to the high-risk factors for the possibility of malignant transformation of gallbladder polyp-like lesions.
(1) Single lesion, larger than 10 mm, with a thick tip, especially if it is located in the neck of the gallbladder and older than 50 years.
(2) Multiple lesions with gallbladder stones, symptomatic, and age >50 years.
(3) Single lesion, less than 10 mm, asymptomatic, age less than 50 years, observation and follow-up are allowed; lesions that increase in size or change in morphology should be treated surgically.
(4) Doppler ultrasound examination of the lesion with abundant blood supply suggests a malignant neoplasm.
(5) CEA (tumor marker), the measured value is significantly elevated and other gastrointestinal tumors are excluded.
(6) Gallbladder polyp-like lesions with significant symptoms and recurrent recurrence.
(7) Asymptomatic patients with diameter less than 5 mm should be followed up at intervals of 3 to 5 months. Once the lesion is enlarged or symptomatic, surgical treatment should be performed.
In recent years, non-surgical and herbal treatment of gallbladder polyp disease has attracted widespread attention in the medical community, various prescriptions, formulas, test prescriptions, etc. in anti-inflammatory, biliary, control of cholecystitis, gallbladder polyps, etc. have achieved certain results, for gallbladder polyps of specialist drugs have also made great achievements, with the in-depth research of Chinese medicine, non-surgical treatment of gallbladder polyps cure rate, is also rapidly increasing.
Prevention
1.Prohibition of alcohol and alcoholic beverages
Alcohol in the body mainly through the liver decomposition, detoxification, so alcohol can directly damage liver function, causing liver and gallbladder dysfunction, so that the secretion and discharge of bile process is disrupted, thus stimulating the formation of new polyps and/or the original polyp growth, larger, increasing the cancer factor of gallbladder polyps.
2, regular diet, breakfast to eat well
Regular diet and good breakfast are extremely important for patients with gallbladder polyps. The liver is responsible for the secretion of bile, which is stored in the gallbladder, and the function of bile is mainly to digest oily food. If you do not eat breakfast, the bile secreted at night is not used, stored in the gallbladder, bile in the gallbladder for too long, you can stimulate the gallbladder to form gallbladder polyps or make the original polyps increase, so it is best to eat some vegetable oil food for breakfast.
3.Low cholesterol diet
Excessive cholesterol intake can increase the metabolic and cleaning burden of liver and gallbladder, and cause excess cholesterol to crystallize, accumulate and precipitate in the gallbladder wall, thus forming polyps, so patients with gallbladder polyps should reduce their cholesterol intake, especially at night, and avoid eating high cholesterol foods such as eggs (especially egg yolk), fatty meat, seafood, scaleless fish, animal offal and other foods.
Review of the problem
After the discovery of gallbladder polyps, how long to review and what method to take to review is also a great concern for patients. Gallbladder polyps should be diagnosed in a hospital with better equipment and higher level of medical technology. Generally, ultrasound is used for review, which can be done once in 3-6 months at the beginning, 2-3 times in a row, and if the polyp does not change, it will be checked again during the annual physical examination or when there are symptoms.
The review should also be done in one hospital, preferably with the same machine and the same doctor. This is because ultrasound examination of gallbladder polyps have errors, the normal error within 2mm, such errors include: personnel error, instrument error, the same machine, the same doctor review, can minimize these errors, especially after taking medication review, the error can easily lead to the effect of medication error judgment.
Patients in the review, it is best not to first tell the doctor how much and how big their gallbladder polyps, so as not to affect the meticulousness and accuracy of the doctor’s examination and diagnosis. Because doctors tend to be more meticulous when looking for the cause of the disease, and tend to go through the motions when reviewing, some are even preconceived. This is bad habit, but sometimes it does exist.
Treatment
1, ultrasound examination found gallbladder polyps, the diameter of 0.5 centimeters or less, often benign polyps. If there are no symptoms, no treatment is needed. However, the ultrasound should be reviewed every six months or so to observe the dynamic changes of the polyps.
2, if the diameter of the polyp is more than 1.0 centimeters, there is a possibility of malignant transformation, should be selected with laparoscopic minimally invasive surgery to remove the gallbladder. After the operation, the removed gallbladder polyps should be subjected to pathological examination to determine the nature of the polyps.
3, for gallbladder polyps whether single or multiple, if there are gallbladder stones (also whether single or multiple), if the symptoms are obvious, frequent abdominal pain, fever, indigestion, the gallbladder should be removed in a timely manner (laparoscopic excision is preferred).
4, patients with gallbladder polyps, diet should be light, avoid greasy food and overeating.
After the removal of gallbladder polyps, the body loses the gallbladder storage, concentration, secretion and secretion of bile and other functions. The problem of fat digestion is that no concentrated bile enters the small intestine, the concentration of bile acids in the intestine is reduced, and the content of bile salts is reduced by half compared with normal people. If the fat content of the ingested food is high, it will cause fat indigestion and affect the absorption of fat-soluble vitamins, after a period of time the body will gradually adapt and compensate, and this process takes 2 to 3 months.
Therefore, during this period of adaptation, the intake of fat should be limited, especially 1 time can not eat food containing too much animal fat. Generally, we use the method of eating less and more meals, and one meal should not be too full. Food content can be low-fat semi-liquid or low-fat soft meals, such as various kinds of porridge, noodles, bread, cookies, tofu, egg whites, fat-free milk, low-fat lean meat, low-fiber vegetables and fruits, etc. Cooking by stewing, steaming or boiling is appropriate. Fat control can be transitioned from 20 grams per day to 40 grams per day, depending on tolerance to food. After a period of adaptation after surgery, the intake of fatty foods will be gradually liberalized.
Cholesterol gallbladder polyps are mainly a collection of cholesterol phagocytosed by a large number of foam cells and inflammatory cells, and a small number of gallbladder epithelial mutant cells. Using PCR and restriction enzyme targeted sequencing, low K-RAS gene activity and high G-RAS gene activity were found in epithelial cells.
The polyps are often multiple, located at the base of the gallbladder or in the body and few in the neck, all small in diameter, with an unsmooth surface, mostly without a tip, no blood supply, strong echogenicity, normal or slightly thick gallbladder wall, and insignificant symptoms such as pain.