During the physical examination, I will do a liver and gallbladder B-ultrasound. What should I do if there is a “gallbladder polyp” on the report?
70% of “gallbladder polyps” are fake
Although they are called “gallbladder polyps”, they are divided into true polyps and pseudo polyps.
Pseudopolyps: cholesterol polyps, focal adenomyosis and inflammatory pseudopolyps;
True polyps: adenoma, adenocarcinoma…
70% of the “gallbladder polyps” detected are pseudopolyps. The true and false can generally be distinguished by B-ultrasound, mainly depending on the echo intensity, and the false cholesterol crystals have a strong echo. If the B-ultrasound cannot be distinguished, examinations such as enhanced magnetic resonance can be used to help. Not all gallbladder polyps are susceptible to cancer. The polyps that can become cancerous are true polyps.
Depending on the size ≥ 1 cm, the true polyp can be cut as long as it can be cut
The larger the polyp, the higher the risk of cancer. Gallbladder cancer is highly malignant. Although cutting the gallbladder has some bad consequences (diarrhea, indigestion…), it is safer to remove it compared to preventing cancer.
The size of polyps is mainly observed by B-ultrasound, but because they are all manually measured, and polyps are not a regular spherical shape, a little error is understandable. For example, how big is the difference between 1.2 mm and 1.5 mm? There may be really no difference. Polyps ≥ 1 cm, the risk is a bit high, if you can operate the gallbladder, cut the gallbladder, after all, gallbladder cancer is too “malignant”; polyps <1 cm, then look at step 3—— Discomfort may come from inflammation or stones Gallbladder polyps smaller than 1 cm are generally unlikely to make people uncomfortable, but gallbladder polyps may indicate the presence of inflammation or stones not found by B-ultrasound. Therefore, with gallbladder polyps, it may be uncomfortable, and this discomfort is generally not caused by polyps, but inflammation or gallstones that are not found. If it is determined that the discomfort is related to the gallbladder, the gallbladder can be removed if surgery is possible; if the discomfort is not related to the gallbladder, continue to check to find out the cause of the discomfort; if there is no discomfort, see the fourth step—— See the risk of 50+ and have the risk of cancer, the gallbladder can be cut Who is prone to gallbladder cancer? Age greater than 50 years; primary sclerosing cholangitis; sessile polyps (including gallbladder wall thickening> 4 mm); Indian ethnicity.
If there is no discomfort for polyps of less than 1 cm: there is a risk of gallbladder cancer, ≥ 6 mm, the gallbladder can be cut; there is a risk of gallbladder cancer, <6 mm, regular B-ultrasound; no risk of gallbladder cancer, regular review B-ultrasound. How often do I review the B-ultrasound? <6 mm, there is a risk of gallbladder cancer: 6 months, 1 year, 2 years, 3 years, 4 years, 5 years; <6 mm, there is no risk of gallbladder cancer: 1 year, 3 years, 5 years; ≥ 6 mm, <1 cm, there is no risk of gallbladder cancer: 6 months, 1 year, 2 years, 3 years, 4 years, 5 years; if you don’t need surgery for the time being, recheck for at least 5 years. If you don’t find it, you don’t need to check again!