Gallbladder polyps

　　The cause of gallbladder polyps is not yet clear, but it is generally believed that the occurrence of the disease is closely related to chronic inflammation. Usually, gallbladder polyps are due to excessive bile secretion, insufficient gallbladder nutrition. Therefore, when the composition of bile changes and the gallbladder over-concentrates bile, the gallbladder is corroded, leading to inflammation, that is, cholecystitis. Over time, the gallbladder wall cannot heal, forming polyps. The following are the causes of gallbladder polyps:

　　1. High cholesterol intake

　　Eating foods high in cholesterol is also a common cause of gallbladder polyps. Irregular diet, overeating of rich and sweet foods, or excessive fatigue can also harm the spleen, leading to poor transformation and the internal generation of phlegm and dampness.

　　2. Overthinking, restless sleep

　　Depression and overthinking harm the spleen, and it is further attacked by external pathogens. The spleen governs the muscles. Overthinking can harm the spleen's Qi, leading to abnormal transformation and nourishment of the muscles. Additionally, being attacked by external pathogens, the battle between the body's resistance and the pathogens reverses in the muscle texture, forming swellings, leading to gallbladder polyps. Disordered digestive function, chronic cholecystitis, and these are all common causes of gallbladder polyps.

　　3. Carcinogenic factors

　　Gallbladder polyps are characterized by a high incidence and a high rate of carcinogenesis. The formation of gallbladder polyps is due to the production of carcinogenic factors within the human body, causing cholesterol accumulation and adenoma mutation, thus forming polyps, and under certain conditions, they can become malignant tumors. This is the cause of gallbladder polyps. Clinically, more than 85% of patients do not require treatment.

　　4. Disharmony between the liver and spleen, Qi and blood stagnation

　　The liver governs the dispersal and the spleen governs transformation, the liver stores blood while the spleen controls blood, anger and depression harm the liver, overthinking harms the spleen, the disorder of dispersal and transformation leads to blood and Qi stagnation, forming tumors. This is a common cause of gallbladder polyps.

　　In addition, there is a certain correlation between male obesity and the existence of gallbladder polyps, while no such correlation exists in women.

　　Gallbladder polyps can easily cause cholecystitis, and the symptoms are only those of cholecystitis. In addition to cholecystitis, what other complications can gallbladder polyps cause?

　　1. Adenomatous hyperplasia

　　A proliferative lesion that is neither inflammatory nor tumor, it is a yellow, soft, warty substance with a diameter of about 5mm, single or multiple. The constituent components are rich in connective tissue containing smooth muscle bundles and goblet cells, with epithelial proliferation and intestinal metaplasia on the surface.

　　2. Cholesterol polyps

　　Cholesterol deposition is an important etiology of gallbladder polyps, where cholesterol deposits in the macrophages of the固有膜of the gallbladder mucosa, gradually protruding towards the mucosal surface, promoting the proliferation of mucosal epithelium, an increase in Rokitansky-Aschoff sinuses, and thickening of the muscular layer, forming polyps. This is the most obvious disease caused by the complications of gallbladder polyps.

　　3. Inflammatory polyps

　　The complications of gallbladder polyps are granulomas caused by inflammatory stimulation, with a diameter of about 5mm, single or multiple, with a broad base. The constituent components include capillaries, fibroblasts, and chronic inflammatory cells. The gallbladder wall around the polyp has obvious inflammation, and there is no report of malignant transformation to date.

　　Gallbladder polyps refer to a general term for a type of lesion in which the gallbladder wall protrudes into the lumen in the form of a polyp, also known as 'gallbladder protrusive lesions'. What are the typical symptoms of gallbladder polyps?

　　1. Unobvious symptoms

　　Gallbladder polyps generally have no symptoms, and most gallbladder polyp patients are found to have the disease during routine physical examinations. In the examination, gallbladder polyps less than 3mm are difficult to be detected in CT and MRI, so they are easily missed. It is recommended that everyone should have a physical examination once a year, and if there is any abnormality in the body, it can be treated early.

　　2. Symptoms similar to chronic cholecystitis

　　Clinical studies show that most gallbladder polyps have symptoms similar to chronic cholecystitis, mainly manifested as mild discomfort in the upper right abdomen, and gallbladder colic may occur when gallbladder polyps are complicated with gallstones. However, a considerable number of gallbladder polyp patients have no symptoms and are only discovered during health examinations. It is generally believed that gallbladder polyps are a triggering factor for gallbladder cancer, and in recent years, there have been many reports on the malignant transformation of gallbladder polyps in China and abroad, especially when accompanied by stones, the chance of malignant transformation will increase significantly.

　　3. Strong concealment of gallbladder polyps

　　Gallbladder polyps have strong concealment and often create the illusion of no pain or illness. It is precisely because of the asymptomatic manifestation of gallbladder polyps in the early stage that patients easily ignore their existence, delaying treatment. When the symptoms of gallbladder polyps occur concurrently or change in nature, they often cause unexpected pain and irreparable harm.

　　Through the introduction of gallbladder polyp symptoms, we understand that gallbladder polyps are a disease with strong concealment, and the early symptoms are often easily ignored by patients. Therefore, regular physical examinations are very necessary, which can help us discover the disease early and prevent irreparable harm.

　　Many people think that gallbladder polyps have no symptoms and there is nothing to worry about. However, gallbladder polyps can still cause other diseases, so we should also pay more attention to prevention in our daily lives.

　　1. Regular meals

　　Regular meals (three meals a day) is the best way to prevent polyps. Because when not eating, the gallbladder is filled with bile, and the gallbladder mucosa absorbs water to make the bile thicker. At this time, cholesterol/lecithin vesicles are easy to form, and the viscosity of bile also increases, eventually forming gallbladder sludge. If eating, when food enters the duodenum, gallbladder contraction hormone is secreted reactively, causing the gallbladder to contract, and at this time, a large amount of thick bile containing gallbladder sludge is excreted into the intestine, thus preventing the formation of polyps.

　　2. Practice good hygiene

　　Practice good hygiene to prevent infection of intestinal worms. Developing good hygiene habits, washing hands before and after meals, washing fruits and vegetables before eating, and maintaining a clean living environment are effective measures to prevent enterobiasis, and are also very helpful in preventing bile pigment polyps.

　　3. Do a good job of deworming

　　Actively treat enterobiasis and biliary enterobiasis. After discovering enterobiasis, it is necessary to take vermifuges in time to prevent the worms from entering the bile duct. If biliary enterobiasis occurs, it should be treated actively to prevent the formation of bile pigment polyps over time.

　　4. Take care of the gallbladder

　　Maintain the contraction function of the gallbladder and prevent long-term stasis of bile. For patients who have been on long-term intravenous nutrition, regular use of gallbladder contraction drugs such as cholecystokinin should be considered.

　　5. Actively treat primary diseases

　　Actively treat the primary diseases that can cause gallbladder polyps. For example, hemolytic anemia and liver cirrhosis, as these diseases are prone to induce gallbladder bile pigment polyps.

　　6. Preventing injurious stricture of extrahepatic bile duct

　　Narrowing of the bile duct can lead to stasis of bile in the bile duct above the narrowing, forming bile pigment polyps. Therefore, it is necessary to avoid injury to the extrahepatic bile duct during upper abdominal surgery, especially during cholecystectomy or subtotal gastrectomy.

　　Gallbladder polyps can be completely asymptomatic and may only be detected during routine ultrasound screening. They can also cause upper abdominal discomfort in the gallbladder area (especially after eating slippery foods), but it is generally mild and may not attract attention. They can also cause bile reflux due to dysfunction of the biliary tract and weakened pyloric function, leading to gastritis or ulcer disease and related symptoms.

　　Common examination methods for gallbladder polyps include ultrasound, color Doppler ultrasound, CT, MRI, cholangiography, etc., among which B-ultrasound is the most commonly used, economical, and has the highest diagnostic rate.

　　If gallbladder polyps patients do not have other special symptoms, they may not need treatment. At this time, patients should pay attention to their diet in daily life. The following is an introduction to the dietary taboos for gallbladder polyps patients:

　　1. Consume more fruits and green vegetables (such as mushrooms, black fungus, celery, sprouts, kelp, lotus root, etc.), pay attention to food hygiene, and always wash fruits and vegetables before eating to prevent ingesting worm eggs.

　　2. Choose vegetable oil for cooking dishes, mainly using braising, stewing, and steaming.

　　3. Eat more lean meats, chicken, fish (except eel) and soy products, etc., but pay attention to moderation and avoid overeating.

　　4. Eat more foods that promote bile secretion and relax the bile duct sphincter, as well as choleretic foods, such as hawthorn, umeboshi, corn silk (infused as tea).

　　5. Eat more foods rich in vitamin A, such as green vegetables, carrots, tomatoes, bok choy, spinach, chives, corn, radishes, etc. Eat more fruits, such as oranges, apples, bananas, etc.

　　Gallbladder polyps may not show clinical symptoms unless they cause cholecystitis. Surgical treatment usually involves cholecystectomy, and in addition to traditional large incision resection, laparoscopic cholecystectomy and small incision cholecystectomy are currently more widely used, as well as cholecystopexy polypectomy.

　　1. Laparoscopic Cholecystectomy

　　It has the advantages of even less trauma and faster recovery. The foreign experience summary of surgical indications is that the gallbladder and surrounding tissues are not severely adherent and there are no other contraindications. Patients with the following symptoms or diseases are not suitable for laparoscopic cholecystectomy:

　　① Individuals not suitable for general anesthesia.

　　② Individuals with jaundice or a history of severe jaundice.

　　③ Individuals with intraductal stones.

　　④ Individuals with a tendency to bleed.

　　⑤ Individuals with liver cirrhosis and portal hypertension.

　　⑥ Individuals with a history of upper abdominal surgery.

　　⑦ Pregnant women with complications.

　　⑧ Obese individuals.

　　2. Laparoscopic Cholecystectomy

　　Laparoscopic cholecystectomy can avoid many disadvantages of large incision surgery and has obvious effects. The small incision technique has a wide range of applications, and it is feasible to perform cholecystotomy exploration, stone removal, and drainage for those with thin abdominal walls, and it has the characteristics of less postoperative pain, fast recovery, and fewer complications. Therefore, laparoscopic cholecystectomy has the advantages of less trauma, fast recovery, and low complications.

　　3. Cholecystopexy Polypectomy

　　If the patient wishes to retain the gallbladder and is under 60 years old and meets the standards for preventive cholecystectomy, for this part of the patients, it is possible to try laparoscopic cholecystoscopy combined with cholecystopexy polypectomy and biopsy, and finally decide whether to keep or remove the gallbladder according to the pathological nature of the polyps in the operation. In this way, it is possible to retain the gallbladders of a part of the patients to the greatest extent.