1.What kind of people are prone to gallbladder polyps?
Gallbladder polyp-like lesions, also known as gallbladder augmentation-like lesions, have no specific clinical symptoms, and most patients are found during physical examination. The main symptom is vague pain in the upper and middle abdomen. The age of onset is mainly young and middle-aged.
People with the following conditions are prone to this disease.
(1) Those who do not eat breakfast or rarely eat breakfast;
(2) Frequent drinkers of alcohol and high cholesterol food, fatty seafood, animal offal;
(3) Social life and work pressure, often irritable, depressed, less physical activity;
(4) often stay up late and irregular life.
2.What are the clinical manifestations of gallbladder polyps?
Most of the symptoms of gallbladder polyps are similar to those of chronic cholecystitis, mainly manifested 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 found 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.
Gallbladder polyps can be clinically divided into three periods, namely: active growth period, relative stability period, absorption and dissipation period in the treatment, generally through the process of “active growth period – relative stability period – absorption and dissipation period”.
3.What tests should be done for gallbladder polyps?
Common examination methods for gallbladder polyps include ultrasound, CT, MRI, etc. Ultrasound examination of gallbladder is the most commonly used, the most economical and the highest rate of diagnosis, the detection rate of <5mm can reach 90% or more, the sensitivity and accuracy of diagnosis are higher. If multiple high-intensity echogenicity with floating sensation and wise-tailed sign is found, it suggests cholesterol polyp, small bulge at the bottom of gallbladder, small round vesicular shadow and scattered echogenic dots in the lesion suggest adenomyomatosis. However, ultrasound examination has some limitations and false negative rate for the diagnosis, characterization and differential diagnosis of this disease. For example, when the lesion is small and located in the neck of the gallbladder, or when accompanied by gallbladder stones, it is easy to cause a missed diagnosis, and it is also difficult to characterize and differentiate.
4.How should gallbladder polyps be treated?
Gallbladder polyp lesions are not uncommon clinically, and surgery is the radical cure, but not all gallbladder polyps need surgical treatment. Because of the different types of lesions, different sizes, disease regression is not the same, so its surgical indications 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) For patients with diameter less than 5 mm, if the patient has no discomfort, no special treatment is needed, just adjust the diet and life pattern, and review the ultrasound once every 3-6 months; if the ultrasound review of gallbladder polyp is significantly larger than before (especially the diameter is more than 5 mm), or combined with gallbladder stones, laparoscopic minimally invasive surgery should be considered. If the gallbladder contraction function and gallbladder physiological status are good, and the gallbladder duct is open, minimally invasive laparoscopic biliary polyp removal can be performed.
(2) For gallbladder polyps with obvious symptoms and recurring patients, minimally invasive surgical treatment is recommended.
(3) Single polyps with size above 5mm or gallbladder polyps located in the neck should be operated regardless of whether they have clinical symptoms or not.
(4) Doppler ultrasound examination of lesions with abundant blood supply suggesting malignant neoplasm should be operated as soon as possible.
(5) If CEA (tumor marker) is significantly elevated and other gastrointestinal tumors are excluded, surgery should be performed as soon as possible.
(6) Those who are suspected of early gallbladder cancer should also be operated as soon as possible.
The harm of gallbladder polyps mainly lies in the malignant transformation of polyps, with the increase of gallbladder polyp volume, the malignant transformation rate is increasing. Once it becomes gallbladder cancer, the main treatment is early surgery, which is not very sensitive to radiotherapy and chemotherapy, and the prognosis is poor. Therefore, the awareness of prevention should be raised, and small polyps should be reviewed regularly and operated in time if there are obvious changes. The Department of Hepatobiliary, Pancreatic and Splenic Surgery of Shandong Jiaotong Hospital adopts the combination of laparoscopy and choledochoscopy to treat gallbladder polyps with polypectomy of ≥5mm, which is less traumatic and faster recovery, and is welcomed by the majority of patients.
5.How to prevent gallbladder polyps?
Prohibition of alcohol and alcoholic beverages
Alcohol is mainly decomposed and detoxified by the liver in the body, so alcohol can directly damage liver function, cause dysfunction of liver and gallbladder, disrupt the secretion and discharge of bile, thus stimulating the gallbladder to form new polyps and/or make the original polyps grow and become larger, increasing the cancer factor of gallbladder polyps.
Eat regularly and have a good breakfast
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 don’t eat breakfast, the bile secreted at night can not be 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 food containing vegetable oil for breakfast.
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.
Develop good habits To overcome unhealthy habits, such as staying up late, smoking, etc., to adhere to outdoor activities and maintain a good state of mind.
Diet precautions
1.It is advisable to eat a variety of fresh fruits and vegetables, into low-fat, low-cholesterol foods such as: mushrooms, fungus, celery, bean sprouts, kelp, lotus root, fish, rabbit meat, chicken, fresh beans, etc.
2.It is advisable to eat more dry beans and their products.
3.It is advisable to use vegetable oil, not animal oil.
4, eat less chili, raw garlic and other stimulating food or spicy food
5.It is advisable to use cooking methods of boiling, steaming, braising, stir-frying, mixing, blanching, stewing, not frying, deep-frying, baking, smoking cooking methods.