How do you get gallbladder polyps?
The detection rate of gallbladder polyps has increased in recent years and has become a common condition. The reasons for this are, on the one hand, due to the increase in the popularity of medical checkups, and on the other hand, may be related to the changes in the dietary structure and dietary patterns of Chinese people and unknown factors such as the living environment, including high-fat diet, high-cholesterol diet, and irregular diet.
Gallbladder polyps are usually asymptomatic
Gallbladder polyps are usually mildly symptomatic or even asymptomatic, and most of them are detected by imaging. Only a few patients have upper abdominal discomfort similar to the symptoms of cholecystitis, polyps located in the neck of the gallbladder can appear biliary colic, in the combination of stones can be biliary colic attacks and acute and chronic inflammatory episodes of performance.
Gallbladder polyps can be good or bad
Gallbladder polyp or polypoid lesion is a general term, generally speaking, the ultrasound report describes a “polypoid lesion of the gallbladder”. This is the name under the imaging examination, the specific gallbladder polyp is good or bad, pathological examination is the gold standard, but through the imaging characteristics can generally determine the benign and malignant.
There are common types of gallbladder polyps as follows.
Cholesterol polyps
It accounts for about more than half of the cases and is also known as pseudopolyp. It is mulberry-shaped in appearance, brittle and fragile, with a thin tip like a cotton thread, which is very easy to fall off, mostly within 10 mm, mainly multiple, and mostly located in the body of the gallbladder. Cholesterol polyps are related to diet, and patients with high cholesterol diet or fatty liver are prone to get cholesterol polyps. No special treatment is needed. Suggestions: regular diet, breakfast, low cholesterol diet, and medications can be tried. The current theory is that these polyps are not cancerous. For cholesterol polyps under 1 cm, regular ultrasound review every 6 months to a year can be done to observe the changes in size, shape and number.
True polyps
It is a piece of “meat” that really grows from the wall of gallbladder, accounting for about 30%, including adenoma, adenomyoma, inflammatory polyp, adenomatous hyperplasia and so on. The ultrasound description will usually include whether the polyp has a wide or narrow base and whether it has a blood supply; polyps with a blood supply are mostly papillomas or adenomas, which have a risk of cancer. Inflammatory polyps are formed by long-term gallbladder stone irritation combined with chronic cholecystitis. Gallbladder adenoma is a benign tumor adenomyosis, adenomatous hyperplasia also has the risk of cancer. If the type and nature of polyps need to be further clarified, enhanced CT or MRI scan is available to help diagnose.
Polyp-type early gallbladder adenocarcinoma
In fact, this type is not strictly speaking the category of what we call gallbladder polyps. At present, for polypoid early gallbladder cancer mixed with gallbladder polyps, it is sometimes difficult to be identified by ultrasound alone, and thin enhancement CT or MRI scan is recommended. Ultrasound features of cancerous polyps are: about 80% are larger than 10 mm and solitary; about 70% are located in the neck of gallbladder, and about half are accompanied by gallbladder stones. Sometimes these tests cannot be 100% certain, and the doctor needs to judge the patient’s condition, sometimes the nature cannot be determined, and even need to review the ultrasound once every 3 months for close observation. Once such a lesion is suspected, it should be treated with surgery as soon as possible.
Does it need to be treated?
Usually gallbladder polyps are asymptomatic and may have been in the stomach for a long time before ultrasound examination. As long as they are not malignant or combined with gallbladder stones or cholecystitis, they usually do not need to be treated actively. When gallbladder polyps are accompanied by stones, they will not only complicate cholecystitis, but also increase the probability of gallbladder polyps becoming cancerous, so it is recommended to remove them.
From clinical experience, the “bad” polyps have the following characteristics: wide base, no tip, single, more than 1cm, increase in size within a short period of time or gradually, appear after the age of 50, combined with gallbladder stones or cholecystitis. In these cases, gallbladder polyps are prone to “problems” and have a high risk of becoming gallbladder cancer. If these characteristics are described above, it is recommended that the gallbladder be surgically removed to eliminate future problems.
Characteristics of benign polyps
If the polyps are small (less than 1cm), multiple, narrow basal, and tipped polyps are relatively less likely to “go wrong”, as long as they are followed up every year, and ultrasound is done about once every six months, if there is any change in the situation, they can be dealt with again.
The surgical treatment of gallbladder polyps has two considerations, on the one hand, to prevent cancer or cancer leakage, on the other hand, for the symptoms, if the uncomfortable symptoms are not relieved by medication, combined with chronic cholecystitis affect normal work and life, you can consider gallbladder removal.
Drugs are not effective for true gallbladder polyps. For multiple cholesterol polyps, some antibiotics may somewhat relieve the symptoms of combined chronic cholecystitis, and may have some effect for some cholesterol crystals less than 5 mm or to prevent new occurrence.
To summarize: short time growing rapidly; larger than 1 cm; solitary; broad-based; gallbladder polyps; with local or whole gallbladder wall thickening; combined with gallbladder stones chronic cholecystitis; ultrasound, CT and MRI do not exclude the possibility of cancer, surgery is usually recommended.
The effect of gallbladder removal on health
The current state of medicine does not believe that removal of the gallbladder will have a major impact on the body: the gallbladder is the organ that stores bile, not the organ that produces it. Some people experience mild diarrhea and bloating for a short period of time after surgery, which tends to occur after eating large amounts of greasy, high-fat foods. This phenomenon can gradually compensate for the missing gallbladder function through hepatic secretion and dilation of the common bile duct, and most diarrhea and bloating can diminish or disappear a few months after surgery. There is no clear evidence from evidence-based medicine that gallbladder removal can cause other diseases in humans. (Click here to see: Effects of gallbladder removal on the body). People who should have their gallbladder removed should not worry about how much it will affect their health. It is only terrible if some polyps are left in the stomach and allowed to develop if they are not removed, but should be analyzed rationally in the context of the disease.
Gallbladder cancer is still a very difficult disease in the medical field, given that the better surgical efficacy of gallbladder cancer is limited to early cancer, and the overall efficacy is very poor, it is not sensitive to radiotherapy and chemotherapy, the only way to improve the treatment effect is early detection and early removal of the gallbladder.
True polyps are a kind of precancerous disease, and the possibility of cancer is the most worrying point. Therefore, further clarification of the nature of the polyps is needed after discovery, as well as regular ultrasound review to dynamically observe the changes in size and shape of the polyps. However, according to statistics, about 12% of the many gallbladder polyps can become cancerous, so in the face of gallbladder polyps, both early detection of signs of malignancy and unnecessary gallbladder removal should be avoided.