Multiple gallbladder polyps, the larger one is 7mmx5mm, it is recommended to continue follow-up observation.
However, there are a few things to keep in mind at the same time:
①With or without inflammation
②Any pain
③Polyp size
④Is it complicated with cholecystolithiasis
⑤Polyp morphology
⑥Assessment of gallbladder function
⑦Are you obese
⑧Is your diet regular
⑨Diabetes mellitus
First, whether to remove gallbladder polyps, there are some suggestions from a surgical perspective as follows:
1. Gallbladder polyps are accompanied by acute inflammation, especially suppurative inflammation, and it is recommended to remove the gallbladder surgically. You can review whether you have acute pain in the gallbladder area over the years, and whether it is accompanied by fever, jaundice, liver damage, and vomiting. If there is, and you ignore it, it may be the manifestation of acute cholecystitis. The gallbladder with acute cholecystitis often turns into chronic cholecystitis.
2. Does the gallbladder polyp repeatedly cause pain in the upper right abdomen, and it is obvious that it is a dull pain in the gallbladder point, and even sometimes affects mood, work efficiency, or is awakened by pain in sleep? In these cases, surgical removal of the gallbladder is recommended.
3. The size of the gallbladder polyp. The relevant surgical consensus recommends that if the gallbladder polyp is ≥1cm, surgical removal of the gallbladder is recommended. For asymptomatic gallbladder polyps with a maximum diameter of 6-9 mm, imaging examinations such as ultrasound should be reviewed every six months. , gallbladder wall thickening > 3 mm, etc.), cholecystectomy should be performed in time.
4. For patients with gallstones, surgical removal of the gallbladder is recommended.
5. Morphology of gallbladder polyps under ultrasound. Gallbladder with wide pedicle, wide base, or thickened gallbladder wall at the junction is a high-risk polyp, and surgical removal of the gallbladder is recommended.
6. Assessment of gallbladder function: poached egg test (gallbladder contractile function test, also known as fat meal test). Ultrasonography was performed on an empty stomach in the morning to measure the size of the gallbladder. After eating two poached eggs, the size of the gallbladder was measured again by ultrasound at an interval of one hour. This is used to calculate the gallbladder excretion function, if the gallbladder excretion rate (contraction rate) after eating
Second, for obese people, it is recommended to control the BMI index within the normal range, while reducing the abdominal circumference, within 90cm for men and 80cm for women.
Third, in terms of diet, pay attention to light nutrition, avoid high oil and high sugar, reduce the intake of fried and barbecued food, and maintain a regular three-meal schedule, and eat only 70% full at each meal.
Fourth, patients with diabetes are often prone to acute inflammation of the gallbladder. While paying attention to the management of chronic diseases of diabetes, timely surgical removal of the gallbladder is recommended when cholecystitis occurs.
References:
Chinese Medical Association Surgery Branch Biliary Tract Surgery Group, Chinese Medical Doctor Association Surgeons Branch Biliary Tract Surgeons Committee. Expert consensus on surgical treatment of benign gallbladder diseases (2021 edition)[J]. Chinese Journal of Surgery, 2021, 59(11): 881-886.
Ruan Xiang, Chen Junjie, Wang Xiang, et al. Interpretation of “American Society of Ultrasound Radiologists Consensus on Management of Gallbladder Polyps (2022)”[J]. Chinese Journal of Practical Surgery, 2022, 42(9) :1005-1009.
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This article was originally written by [Dr. Luo Health Talk]. The author is a member of the Chinese Anti-Cancer Association, a member of the Health Communication Committee of the Chinese Medical Doctor Association, and a health science writer. You are welcome to forward, comment, and like. Or private message to communicate with me, thank you very much!