1.What is gallbladder polyp?
A type of lesion in which the wall of the gallbladder bulges into the lumen in a polyp-like fashion.
The etiology is not known.
Asymptomatic (ultrasound findings) or painful discomfort in the right upper abdomen.
May be related to chronic inflammation of the gallbladder.
2, benign gallbladder polyps?
Non-neoplastic polyps: benign redundant organisms in the inner wall of the gallbladder, usually less than 10mm in diameter;
Cholesterol polyps: 10% to 25% of gallbladder resection specimens are present
inflammatory polyps: inflammatory granuloma-like changes in the gallbladder mucosa, single or multiple, usually without a tip
Adenomatous hyperplasia: with mucosal glandular epithelial metaplasia, single or multiple.
3.Neoplastic polyps of gallbladder?
Solitary gallbladder adenoma: mostly solitary, with short tissues.
papillary adenoma: also mostly solitary, with short tissues
Intracholangiocarcinoma: early carcinoma, diameter greater than 10mm.
4. adenomyosis of the gallbladder?
unknown etiology.
Mucosal epithelial hyperplasia,thickening of the muscular layer, showing augmentation-like lesions.
dilatation of the a-lost sinus into a cystic shape, forming a pseudodiverticulum.
May be combined with inflammation or stones in the alar sinus.
It is often accompanied by right upper abdominal pain.
5. What are the “bulging lesions” of the gallbladder that need to be identified?
Submucosal lipoma of the gallbladder.
Smooth muscle tumor of the gallbladder.
Mesenchymal stromal tumor of the gallbladder.
Ectopic pancreas.
Gallbladder hemangioma, etc.
6.Symptoms of gallbladder polyps?
Mostly right upper abdominal discomfort or asymptomatic.
Abdominal pain.
Vomiting.
Aversion to oil.
Abdominal distension and diarrhea.
Individuals with biliary colic.
7, ultrasound examination of gallbladder polyps?
Preferred.
Multiple small bulges in the gallbladder, mostly cholesterol polyps.
rounded bulges within the gallbladder, mostly inflammatory polyps or adenomatous polyps.
limited thickening of the gallbladder lining, possibly adenomyosis.
Diameter greater than 10mm, no tip, uneven echogenicity, may be polyp carcinoma or intracholangiocarcinoma.
8.Risk factors of gallbladder polyps?
Polyps larger than 10mm;
Middle-aged and elderly patients.
Single polyp, without a tip.
9.What are the indications for gallbladder polyp surgery?
Diameter <10mm, asymptomatic, regular ultrasound examination reveals rapid growth, preventive cholecystectomy is possible.
At present, many patients with gallbladder polyps 6mm-8mm, that is, actively choose cholecystectomy.
Patients with diameter >10mm, age >50 years, single, broad-based, combined with gallbladder stones, obvious symptoms and suspected polyp malignancy or gallbladder cancer.
10.Surgical methods of gallbladder polyps?
Never bail out polyps.
Non-neoplastic polyps: laparoscopic cholecystectomy is preferred.
neoplastic polyps, routine open cholecystectomy with routine intraoperative frozen section.
For cancerous polyps, simple cholecystectomy is feasible when the tumor is confined 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.