Multiple gallbladder polyps

　　The latest research shows that the onset of gallbladder polyps is due to emotional disorders (depression, depression, irritability), dietary injury (overeating of fat and sugar, excessive drinking), overwork and rest (overwork, overfatigue, overindulgence in leisure), and external pathogenic factors (summer dampness, wind-cold). Liver and gallbladder fail to discharge, Qi stagnation, blood circulation is not smooth, bile secretion and excretion are not favorable, damp-heat accumulation, blood stasis inside, and after a long time, the symptoms of mass and accumulation are formed. The symptoms are mixed with deficiency and excess.

　　The most common type of gallbladder polyp is cholesterol polyp, which is related to the disorder of cholesterol metabolism. Cholesterol polyps are often multiple and small, mostly 3 to 5 millimeters in size, generally not exceeding 1 centimeter, and do not grow rapidly. The number of polyps can change during the observation process. Some polyps can even fall off and be excreted with bile. However, occasionally, there are solitary ones, with only one polyp, and the diameter can also be greater than 1 centimeter, which is rare. Cholesterol polyps do not become malignant and become gallbladder cancer, but sometimes they can form gallstones. If there are no自觉 symptoms, no treatment is needed.

　　The next is inflammatory polyps, which are caused by chronic inflammation of the gallbladder, so they often occur in the situation of gallbladder calculi and chronic cholecystitis, and are not true tumors. The lesions that cause inflammatory polyps need to be treated, not the inflammatory polyps themselves.

　　Concurrent cholecystolithiasis and cholangiocarcinoma. Polypoid cholangiocarcinoma accounts for 9% to 12%, with BUS features of >10mm, predominantly solitary (82%), mostly located at the gallbladder neck (70%), and the lesions are mainly medium and low echoic, about 50% accompanied by gallstones. When these features are present, radical cholecystectomy should be performed early, and the connective tissue above and below the cystic duct and the fibroadipose tissue of the gallbladder bed should be cleared together.

　　Most symptoms of gallbladder polyps are similar to those of chronic cholecystitis, mainly manifested as mild discomfort in the upper right abdomen. When stones are present, cholecystalgia may occur. However, a significant number of patients have no symptoms and are only discovered during health physical examinations. It is generally believed that gallbladder polyps are a predisposing factor for gallbladder cancer. In recent years, there have been many reports on the canceration of gallbladder polyps abroad, especially when stones are present, the risk of canceration will increase significantly.

　　Gallbladder polyps can be divided into three stages in clinical practice: active growth period, relative stability period, and absorption and resolution period. During treatment, patients generally go through the process of 'active growth period - relative stability period - absorption and resolution period'.

　　Clinical characteristics of gallbladder polyps

　　Gradually increasing incidence

　　With the diversification of human dietary structure, irregular dietary rhythms, and the exacerbation of environmental pollution, the incidence of gallbladder polyps has gradually increased. Factors such as high-cholesterol diet, long-term alcohol abuse, excessive intake of spicy foods, irregular diet such as not having a good breakfast or not eating breakfast, excessive dinner, and other bad eating habits, excessive pesticides,泛滥的食品添加剂, and ionizing radiation filling the space are all directly and indirectly related to the formation of gallbladder polyps, thus giving rise to the first characteristic of gallbladder polyps - the gradual increase in incidence.

　　Stealthy and aggressive

　　Gallbladder polyps often have no symptoms, with more than 85% of patients being discovered during routine physical examinations. In terms of examination, polyps less than 3-4mm in size are difficult to detect or often missed in CT and MRI scans.

　　High rate of canceration

　　The fatal damage of gallbladder polyps lies in sudden canceration. From the 1980s to the 1990s, the rate of canceration gradually increased due to the different nature of gallbladder polyps formed. Many patients with gallbladder polyps do not have any discomfort during canceration or after canceration, and they develop and undergo canceration without realizing it. This is the most terrifying characteristic of gallbladder polyps.

　　Abstain from alcohol and alcoholic beverages

　　Alcohol is mainly metabolized and detoxified by the liver, so alcohol can directly damage liver function, cause dysregulation of liver and gallbladder function, and disorder the secretion and excretion process of bile, thereby stimulating the formation of new polyps in the gallbladder or causing existing polyps to grow larger, increasing the risk of gallbladder polyps becoming cancerous.

　　Diet should be regular, and breakfast should be good

　　Regular diet and a good breakfast are extremely important for patients with gallbladder polyps. The liver in the human body is responsible for secreting bile, which is stored in the gallbladder. The main function of bile is to digest fatty foods. If breakfast is not eaten, the bile secreted at night cannot be utilized and will remain in the gallbladder. Prolonged retention of bile in the gallbladder can stimulate the formation of gallbladder polyps or cause existing polyps to grow larger and increase in number. Therefore, it is best to have some food containing vegetable oil for breakfast.

　　Low cholesterol diet

　　Excessive cholesterol intake can increase the metabolic burden on the liver and gallbladder, leading to crystallization, accumulation, and sedimentation of excess cholesterol on the gallbladder wall, thus forming polyps. Therefore, patients with gallbladder polyps should reduce their intake of cholesterol, especially at night, and avoid eating high-cholesterol foods such as eggs (especially yolks), fatty meats, seafood, scaleless fish, and animal internal organs.

　　Abdominal examination usually has no positive signs. Its diagnosis depends on B-ultrasound or CT and other imaging diagnoses.

　　High-resolution real-time ultrasound imaging equipment can reach a diagnostic rate of 83.3% to 93.5% for PLG, and can detect lesions with a diameter of 2mm, and the detection rate of lesions smaller than 5mm is not comparable to other imaging methods. PLG ultrasound sonogram shows gallbladder wall nodular or papillary elevation into the cavity, with isoechogenicity or strong echo, without shadowing, and not moving with body position change. Ultrasound detection can determine the number, location, and size of PLG, but it is difficult to determine the nature of the lesion. The specificity of ultrasound diagnosis of PLG reaches 94.8%, but false positives can occur due to the following conditions: gallbladder pleats, gallstones, thick bile clots, necrotic tissue shedding, and blood clots. These lesions can be distinguished by changing body position. If the lesion is small and located at the gallbladder neck, or if PLG diagnosis is ignored due to the presence of stones, false negatives may occur. Color Doppler ultrasound detection of blood flow signals and blood flow conditions in PLG helps in the qualitative diagnosis of the lesion.

　　Oral cholecystography has a detection rate of only 13.5% to 18.2% for PLG; due to the small size of PLG lesions, they are difficult to display. CT has a diagnostic rate of 75% to 82% for PLG, and it is expensive, and it is only used as a supplementary diagnostic method for ultrasound. Endoscopic ultrasound is not affected by intestinal gas and obesity factors, can clearly display the three-layer structure of the gallbladder wall, can improve the early detection rate of gallbladder cancer, and can determine the depth of tumor infiltration, but the detection rate of gallbladder base lesions is low, and it is not yet widely used in clinical practice.

　　It is recommended to eat a variety of fresh fruits and vegetables, and low-fat, low-cholesterol foods such as mushrooms, wood ear, celery, sprouts, kelp, lotus root, fish meat, rabbit meat, chicken meat, fresh beans, and so on.

　　It is recommended to eat more dried beans and their products.

　　It is recommended to use vegetable oil, not animal oil.

　　It is recommended to eat less chili, raw garlic, and other spicy or刺激性 food.

　　It is recommended to use cooking methods such as boiling, steaming, braising, frying, mixing, skimming, and stewing, and not to use cooking methods such as frying, frying, roasting, and smoking.

　　Take 10 grams of hawthorn, 10 grams of chrysanthemum, and 15 grams of cassia seed, and decoct them into a decoction to drink as tea or green tea.

　　In daily life, while drinking water, squeeze a small amount of hawthorn, ginkgo, and astragalus grass into the cup as tea.

　　Regular diet and a good breakfast are extremely important for patients with gallbladder polyps. The liver in the human body is responsible for secreting bile, which is stored in the gallbladder. The main function of bile is to digest oily foods.

　　Gallbladder polyps are not uncommon in clinical practice, and surgery is the method for根治, but not all gallbladder polyps require surgical treatment. Due to the different types of lesions, varying sizes, and different disease outcomes, the surgical indications are also inconsistent among different medical institutions.
　　Selection of the timing for surgery: Gallbladder polyp-like lesions are sometimes difficult to identify before surgery. Based on the high-risk factors of gallbladder polyp-like lesions, we propose the following surgical indications:
　　(1) Unilateral lesion, greater than 10mm, thick pedicle, especially located at the neck of the gallbladder, age greater than 50 years old. (2) Multiple lesions, accompanied by gallstones, with symptoms, age greater than 50 years old. (3) Unilateral lesion, less than 10mm, asymptomatic, age less than 50 years old, allowed for observation and follow-up; if the lesion increases in size or changes in shape, surgical treatment should be performed. (4) Doppler color Doppler ultrasound examination shows rich blood supply of the lesion, indicating malignant neoplasm. (5) CEA (tumor marker), significantly elevated and excluding other gastrointestinal tumors. (6) Gallbladder polyp-like lesions with obvious symptoms and recurrent occurrences. (7) For patients with asymptomatic lesions less than 5mm in diameter, follow-up examinations should be conducted every 3 to 5 months. If the lesion increases in size or symptoms become obvious, surgical treatment should also be performed.
　　The Treatment Mechanism of Gallbladder Polyps

　　One, correct the formation of gallbladder bile, prevent the growth and regeneration of polyps.

　　Two, change the local microenvironment of the lesion, cut off the nutrition supply of the polyp, causing the tumor body to dry up, shrink, and necrotize from the root, 'tumor death and pedicle fall off', and be excreted out of the body through the body cavity with feces.
　　Three, the active ingredients attach to the surface of the tumor body, penetrate into the polyp tissue and directly kill the cells, rendering them inactive and unable to regenerate. Decompose the necrotic tissue, repair the basal tissue, and restore the function of the stomach and intestines.
　　Four, comprehensively adjust the human body's immune function, correct the imbalance of the body, and protect the gallbladder by activating and enhancing the human immune system (including humoral immunity and cellular immunity) to increase the monitoring of humoral immunity against irritants, promote the phagocytosis of lymphocytes, mononuclear phagocytes, and macrophages on polyp tissue, correct the internal environment regulation of gallbladder irritability, adjust the irritability and inhibitory gene to the normal balanced state, thereby curing gallbladder polyps. This therapy starts with adjusting and reversing the overall pathological factors of the patient, balancing yin and yang, and can fundamentally make gallbladder polyps gradually shrink and absorb, ultimately completely disappear, thereby achieving the purpose of complete recovery. Clinical observation of tens of thousands of cases has shown significant efficacy, and generally, recovery can be achieved within 1-3 months.