How to deal with this problem? There are basically two options: observation and waiting and cholecystectomy.
1, the polyp is equal to or greater than 10 mm, and it is more likely to become cancerous or become cancerous with time. Especially polyps larger than 15mm or larger have a 46%~70% chance of containing cancer cells. Cholecystectomy should be selected for gallbladder polyps equal to or greater than 10 mm, and pathological examination should be performed during and after operation.
2. Polyps smaller than 10 mm will not become cancerous, and should be monitored regularly, carefully observed and followed up by ultrasound, without surgery. You can use Lishu liniment to inhibit polyps, then control your diet and eat less high-cholesterol foods to avoid excessive bile and cause polyps to grow.
1. What is gallbladder polyp?
Gallbladder polyp is a protrusion on the inner wall of gallbladder.
Second, what are the symptoms of gallbladder polyps?
Most people are asymptomatic. A few patients have pain and discomfort in the upper abdomen, and a few people's polyp shedding can cause gallbladder obstruction and lead to acute cholecystitis. 95% of gallbladder polyps are benign polyps, and a few have malignant transformation. How to diagnose benign and malignant polyps has become the key to the diagnosis and treatment of gallbladder polyps.
Third, how to diagnose gallbladder polyps?
In order to better observe the gallbladder, ultrasound examination is usually the first choice. The diagnostic rate of gallbladder polyps larger than 6 mm can reach 100%.
Usually, ultrasound can see the existence, quantity and location of polyps in gallbladder and their relationship with gallbladder wall. It can also measure the size of polyps to help predict benign and malignant polyps and assess potential risks. However, the detection rate of CT for gallbladder polyps is only 40%, which is not the first choice for examination.
With the progress of medical equipment and examination technology, especially the popularity of ultrasound examination in health examination, more and more people find gallbladder polyps in annual health examination. In recent years, I also found that gallbladder polyps, thyroid nodules and kidney calculi have become the most common diseases in the investigation of employees' health checkups. When it comes to gallbladder polyps, many people are full of fear of the unknown "polyps". Although some are less than 0.5cm, they are still worried that they will become cancerous in the future. Generally, they will ask health inspectors questions. Today, I will talk to you in detail about the following gallbladder polyps and the treatment of gallbladder polyps.
Did the physical examination find gallbladder polyps serious? How to deal with it?
How is gallbladder polyp produced?
The pathological name of gallbladder polyp is "polypoid lesion of gallbladder", which is simply a "pimple" growing in the gallbladder cavity. The results of epidemiological studies on gallbladder polyps abroad show that 4.6% of men and 4.3% of women have gallbladder polyps. With the improvement of ultrasonic technology and the popularization of equipment, this number will continue to rise.
Did the physical examination find gallbladder polyps serious? How to deal with it?
Ultrasonic manifestations of gallbladder polyps
Most people will think it's because young people don't like breakfast. This statement has no basis. Some doctors think it has something to do with the way the body metabolizes lipids. When cholesterol is supersaturated and deposited in the lamina propria of gallbladder mucosa, it further invades the mucosal space, is swallowed up by macrophages to form foam cells, and gathers in the interstitial layer to promote the formation of cholesterol polyps. This is the main reason for the increase of cholesterol polyps at present. However, its incidence is not necessarily related to age, sex, weight, exercise, drinking, diet and blood lipid. At present, the medical community can not fully confirm the cause of gallbladder polyps, but it is generally believed that it is related to gallstones, chronic cholecystitis, or the increase of gallbladder internal pressure caused by biliary obstruction. The incidence is more common in young and middle-aged women. Clinical research shows that nearly 70% patients with gallbladder polyps are complicated with gallstones.
Gallbladder polyps (GP) are classified as benign or malignant, and the detection rate of ultrasound in adults is 4.2% ~ 6.9%. Polyps may become cancerous, but it rarely happens.
Benign GP is subdivided into: pseudotumor (cholesterol polyp, inflammatory polyp; Cholesterol deposition and hyperplasia), epithelial tumor (adenoma) and mesenchymal tumor (fibroma, lipoma and hemangioma), about 95% of gallbladder polyps are benign. According to some literature reports, the incidence of cholesterol polyps accounts for 60%. The so-called cholesterol polyp is that cholesterol crystals are deposited on the inside of the gallbladder, causing mucosal hyperplasia. Cholesterol polyp accounts for 80% ~ 85% of all polypoid lesions of gallbladder, and tumor polyp accounts for 10% ~ 15%.
"Gallbladder adenoma" is a kind of gallbladder polyp that deserves special attention. Although it is considered as a non-neoplastic polyp, it is a benign lesion. However, because its clinical symptoms are similar to those of gallstones and cholecystitis, and its imaging results are similar to those of early gallbladder cancer, it needs a number of precise examinations to make a diagnosis. Some scholars believe that gallbladder adenomyoma is a precancerous lesion, which will increase the risk of gallbladder cancer by 6.6%, and the elderly over 60 years old are more likely to develop into malignant tumors.
Malignant GP is gallbladder cancer, and adenocarcinoma is the most common. According to the international practice, the cancer incidence data released by the National Cancer Center (NCCR) and WHO combined gallbladder and extrahepatic cholangiocarcinoma for statistics, referred to as gallbladder cancer. According to the latest figures of National Cancer Center, the incidence of gallbladder cancer in China is (1.00 ~1.30)/65438+ten thousand, and it is pointed out that gallbladder cancer is not the most common malignant tumor in digestive system and biliary system.
In the cohort study of 622,227 participants aged 65,438+08 and above in 2020, it was found that the growth of gallbladder polyps was very common during the 20-year follow-up. Among polyps smaller than 6mm, 66% grew up, while among polyps of 6-65,438+00 mm, 53% grew up. Nevertheless, gallbladder cancer rarely occurs in patients with gallbladder polyps, with a total incidence rate of 65,438+065,438+0.3 cases/65,438+million person-years, while among patients observed for at least 65,438+0 years, the incidence rate is 3.6 cases/65,438+million person-years.
However, although the incidence of gallbladder cancer is very low, the degree of malignancy is high and the prognosis is poor. At present, there is no effective treatment for this disease. If it can be removed early, chemotherapy or radiotherapy has little effect, and surgery is the first choice. Locally advanced tumors may involve duodenum/pylorus/hepatic curvature/biliary system; In these cases, the tumor is removed together with the affected organs, and the prognosis is poor. Therefore, it is necessary to strengthen the early diagnosis and treatment of gallbladder cancer.
The only indication of gallbladder polyp surgery is the risk of cancer. Although mentioned earlier, the probability of gallbladder polyposis becoming malignant tumor is very low, if it is multiple polyps, most of the slow-growing polyps with a base less than 10mm will be considered as cholesterol polyps, and pseudopolyps and inflammatory polyps that do not cause symptoms do not need treatment.
In 20 19, BMC gastroenterology published a study. After 1 1 year follow-up since 2002, it was found that the prevalence of gallbladder polyps increased, and 8.7% of the population showed new lesions, which may be the reason for the progress of ultrasound technology. In the initial 5 1.9% subjects, polyps persisted, while in the other 48. 1% subjects, polyps disappeared, which also indicated that gallbladder polyps might disappear on their own.
However, if there are the following four kinds of gallbladder polyps, you need to pay attention.
1, single polyp;
2. If the polyp causes symptoms, it may be greater than 65438±0cm；;
3. During the follow-up period of 1 year, polyps continued to grow, with an increase of more than 2 mm over the previous one.
4. Have symptoms of gallstones or gallbladder adenoma, or have a family history of gallbladder cancer.
Generally speaking, most people with gallbladder polyps have no obvious symptoms. If the situation is serious, they may have symptoms similar to cholecystitis or gallstones, such as nausea, vomiting, flatulence in the upper abdomen, dull pain in the right upper abdomen, and a few even radiate pain to the right shoulder, which requires surgical consultation for cholecystectomy. If there is no cholecystectomy, annual follow-up is necessary.