With the enhancement of public health awareness, more and more people have participated in physical examinations in recent years. When the words "bulging lesions in the gallbladder, gallbladder polyps may be possible" on the physical examination report, many people panicked.
What exactly is a gallbladder polyp?Will it become cancerous?Do I need surgery?All kinds of question marks emerge along with the physical examination report, so how to face the "gallbladder polyp" correctly?
Health Recommender: Cai Lihua, Deputy Chief Physician of the Department of Ultrasound Medicine, Luoyang Oriental People's Hospital (the Third Affiliated Hospital of Henan University of Science and Technology).
Gallbladder polyps are not terrible, and most patients do not need to be particularly **, but some polyps with malignant potential should not be ignored. Cai Lihua said that gallbladder polyps actually refer to gallbladder polypoid lesions, also known as gallbladder bulge lesions, which are a series of bulging lesions on the gallbladder wall that protrude into the gallbladder cavity. Patients with gallbladder polyps are generally asymptomatic and are usually found by ultrasonography during physical examination, and a small number of patients have only mild epigastric discomfort or vague pain.
Gallbladder polyps are usually divided into two categories: non-neoplastic polyps (pseudopolyps) and neoplastic polyps (true polyps), with cholesterol polyps being the most common, followed by inflammatory polyps, adenomatous hyperplasia, and gallbladder adenomyosis. Neoplastic polyps are mainly benign adenomas and malignant gallbladder cancer.
Cai Lihua said that cholesterol polyps account for more than 80% of all gallbladder polypoid lesions, benign non-cholesterol polypoid lesions account for 10%-15%, and neoplastic polyps account for about 5%.
Gallbladder polypoid lesions are common in the population and are almost always detected inadvertently during routine ultrasonography. The symptoms of gallbladder polyps are highly insidious and the symptoms are not obvious. Cai Lihua said that the symptoms of some gallbladder polyps are similar to chronic cholecystitis, mainly manifested as mild discomfort in the right upper abdomen, involving the back of the right shoulder, while other gallbladder polyp patients have no symptoms and can only be detected during a health check-up.
Ultrasonography is the preferred method for detecting polypoid lesions in the gallbladder. In addition to the commonly used ultrasound, gallbladder polyps can also be found by contrast-enhanced ultrasound, CT, MRI, etc. (note: fasting is required before ultrasonography of the gallbladder, because the fasting gallbladder can have enough bile filling, which is conducive to the detection of lesions).
Gallbladder polyps are mostly manifested as single or multiple isoechoic or hyperechoic bulge lesions on the gallbladder wall on conventional ultrasound, which are generally small, generally no more than 10 mm in diameter, and have no sound shadow behind them, pedicle or sessile, and will not move with the change of body position.
As shown by the arrows: single gallbladder polyp at the top and multiple gallbladder polyps at the bottom).
Gallbladder polyps can be easily detected by routine ultrasonography, but it is difficult to distinguish between true and false, so regular follow-up is required. The duration of regular follow-up can vary depending on the diameter: less than 6 mm, it can be repeated every 1 to 2 years;6 to 8 mm, rechecking every 6 months is recommended;8 to 9 mm, can be rechecked every 3 months.
When the polyp diameter increases significantly (usually more than 10 mm in diameter) by comparing the size of the polyp, gallbladder adenoma or gallbladder adenocarcinoma is considered and surgical intervention is required. If the polyp is single and the pedicle of the polyp shows vascular signs, close observation and follow-up are required.
Gallbladder polyps can be examined with contrast-enhanced ultrasonography in addition to regular follow-up observations with conventional ultrasound. Contrast-enhanced ultrasonography requires intravenous injection of a contrast agent, which is followed by ultrasound to observe the blood flow in the polyp in real time to distinguish the nature of gallbladder polyps.
If you have gallbladder polyps, what should I pay attention to in my daily diet?
Patients with gallbladder polyps should avoid spicy and irritating foods, such as chili peppers and garlic, which may stimulate gallbladder contraction, induce inflammation, and aggravate symptomsPatients with gallbladder polyps should limit cholesterol intake, such as animal offal, animal fat, egg yolk, etc., because gallbladder polyps may be induced by the body's abnormal cholesterol metabolism leading to the accumulation of unmetabolized cholesterol in the gallbladder wallAvoid overeating, overeating may aggravate the excretion of bile, promote gallbladder contraction, thereby aggravating the motor contractile function of the gallbladder, enhance the motor capacity of gallbladder polyps, and make gallbladder polyps painful, so patients with gallbladder polyps should avoid overeating. (Guan Caiqing, You Yunfei).