Polyps in the gallbladder – a tumor that is tumor-like. Their development is possible for a variety of reasons, they are formed inside the organ on its wall and grow inward. As a rule, they are of a benign nature, but under the influence of certain factors they can turn into a cancer. How does this happen? How can these diseases be detected and treated? How to treat polyposis in the gallbladder?
- What are polyps in the gallbladder
- Types of Polyps
- Why are gallbladder polyps dangerous?
- The causes of polyps
- Signs and symptoms of polyps
- Diagnosis of polyps in the gallbladder
- What to do with polyps in the gallbladder
- Is it possible to cure polyps in the gallbladder without surgery
- How to treat gallbladder polyposis with pills
- Ursosan for polyps in the gallbladder
- In what cases is surgery done in the gallbladder for polyps?
- The risk of becoming cancer
- Hepatic colic
- Cholecystitis and inflammation
- Problems with excretion of bile and increased bilirubin
- Types of cholecystectomy
- Laparoscopic surgery
- Open operation
- Recovery after surgery
- Physical exercises
What are polyps in the gallbladder
These phenomena – polyps in the gallbladder – are considered an abnormal condition for the body. This is the growth of the epithelium on the very wall of the gallbladder, which continues to grow inward. The polyp is recorded in the MDB, and there is not one code, but several. This means that it is designated as ICD-10 K80-87. Under these codes are located in the international classification of diseases of the gallbladder and other digestive organs, as well as under the code D37.6 – neoplasms. This classification can describe all possible types and forms that can explain what polyps are. The classification can be differentiated, which means to disassemble the types of formations into similar components – the main cholesterol polyp, the appearance of papillomas, polyposis of the gallbladder and inflammatory formations.
It is important to understand that if polyps have already formed in the gallbladder, then this does not mean that the first symptoms will begin immediately. They grow little by little on the back wall of the gallbladder and do not cause discomfort until they begin to disrupt the blood supply, cause poor health, IVP and so on. And the opposite situation is also possible, where parietal polyps begin their growth from the neck of the gallbladder, blocking the already difficult outflow of bile. This provokes a condition in which colic and other signs of the disease appear much faster and more acutely.
A polyp is considered a benign formation, but it needs constant monitoring, regardless of its form. This is due to the fact that even a benign neoplasm can degenerate into a cancerous tumor, which will require urgent surgical intervention. And as long as the formation is not cancerous, it simply interferes with the normal functioning of the digestive organs and creates a bitter belching, sometimes accompanied by nausea.
Types of Polyps
There are 4 varieties, and all of them are difficult to diagnose at the onset of the disease, because they are asymptomatic. Polyps formed in the gallbladder have only hypothetical reasons for their appearance, since they have not been fully understood. Types of polyps localized in the gallbladder:
- Papilloma in the gallbladder. It has an original benign nature, however, certain circumstances turn it into oncology. Differs in papillary configuration. Papillomas in the gallbladder require treatment with surgery and close observation.
- Polypoid formations of an inflammatory nature. Such neoplasms cannot be called a tumor. Their formation is possible only if inflammation develops or an irritating factor is affected. With the removal of the causes of irritation and proper treatment, they dissolve on their own.
- Benign adenomatous formations. The gradual proliferation of glandular tissue, which is provoked by polyposis formations of the gallbladder, requires close monitoring of the development of the situation and surgical treatment at the first signs of a transition to a malignant tumor.
- Cholesterol polyps. A cholesterol polyp formed in the gallbladder is called a pseudopolyp or pseudotumor. After all, correctly selected treatment, started in a timely manner, allows you to cope with them.
Why are gallbladder polyps dangerous?
The first question that arises in a person with an established diagnosis is what is the danger of a gallbladder polyp. The neoplasm itself has a non-cancerous structure, but the gallbladder is in serious danger. This is due to the fact that benign growths are dangerous due to the ability to easily be reborn, and then relatively harmless formations become oncology. It is worth noting that much more often this disease affects women over 30 years old. In men, cholesterol, as well as inflammatory nature, the polyp of the gallbladder occurs much less frequently.
At the same time, is it dangerous not to undergo frequent examinations for both sexes? Scientists cannot give a definite answer. It is only known that refusal of treatment can cause many complications, the consequences of which are unpredictable. Polyposis is able to cause other neoplasms in any digestive organs, as well as malignant neoplasms. Gradually, without proper therapy, polyps grow. This disease does not progress very much when children become its victims, because their organs grow extremely quickly and the polyp does not have time to gain a foothold.
The causes of polyps
No disease or formation inside the body appears without a reason. The causes of polyps are very different, among which there are congenital and acquired:
- inherited and genetic pathologies of the work and development of organs,
- inflammation in the gallbladder, provoking its diseases,
- changes in metabolic processes in the body,
- biliary dyskinesia,
- other diseases that disrupt the work of the bile drainage system.
Polyps in the gallbladder often have genetic causes. Also, this group includes predispositions that are genetically transmitted from blood relatives. Tumors of benign origin are considered both papillomas and polyps of adenomatous origin, therefore, such a formation in the gastrointestinal tract can be a hereditary disease. If a person had patients in the family who had cancerous tumors in any organ, then the question of where the polyps in the gallbladder come from is not even worth discussing. This is why polyps appear.
In addition, heredity and its psychosomatics are such that any disease, with the development of which polyps may appear, provokes their appearance. There is even a predisposition to dyskinesia, poor bile conductivity, and polyposis in the bile ducts in symbiosis with calcified neoplasms. In this situation, bile passes through the ducts with great difficulty and a large number of associated disorders arise.
However, it cannot be assumed that polyps appeared only due to weighed down heredity. This disease can have different causes, and psychosomatic causes among them are not the least. If a person constantly looks for a disease in himself, worries about this, then he will either find the disease, or provoke its appearance by constant nervous states. Polyp may be simply the result of bile stagnation, and relatives who have died of cancer will not be involved at all.
Another important reason, as a result of which a polyp appears out of nowhere, is the process of inflammation inside the organ. First of all, it is worth noting the presence of cholestasis bile stagnation and chronic cholecystitis. Bile stagnation accompanies both of these inflammations, and the appearance of polyps, if present, will not keep you waiting. The main symptom in this case is soreness in the right side under the ribs, which usually intensifies after eating any food and physical activity. Pain syndrome is able to change its location and be transmitted to any part of the body, usually to the scapula. Soreness in this case is usually dull and comes in attacks, but after eating fatty foods, it can briefly intensify and acquire the character of colic. This pain, at its peak, can cause not only nausea, but also vomiting.
When nothing hurts, the patient is usually disturbed by an unpleasant belching, and in the morning he is nauseous before eating. This situation in the digestive process is explained by the excess amount of bile. The inflammatory process provokes such a work of the gastrointestinal tract, due to which then the growth and deformation of the tissues of the wall of the gallbladder occurs. The inflammation provokes an increase in the amount of granulation tissue that is present on the circumference of the organ. This is how pseudopolyps begin to form.
Another reason is the distortion of exchange processes. Cholesterol polyps or pseudopolyps are formed quite often for this reason. Cholesterol gradually builds up on the wall of the mucous organ, gradually growing inward over time. Under the influence of calcium salts, which are abundant in cholesterol, these formations gradually calcify. This process is usually caused by disturbances in lipid metabolism, with its manifestations in the blood, the amount of cholesterol usually rises.
Stagnation of bile is able to provoke the appearance of cholesterol build-ups even in the case where its amount in the body is not exceeded. If the concentration in the blood is 5,0 and higher, then the rate of pseudopolyp formation only increases. Unfortunately, this type of disease does not give itself out for a long time, so often the patient does not turn to a specialist on time. And at the time of going to the doctor, the process has already started and requires serious treatment.
The last reason among the main ones can be called biliary dyskinesia, which is a functional disorder. It is important to note that there are no violations of the structure of the organ. This change in the normal functioning of the organ is usually caused by either an increased or a lack of contractions of the gallbladder. Any causes that cause insufficient contractions and a lack of bile release cause a bile deficiency in the body. Thanks to this, the digestion of food is disturbed, the patient experiences pain during eating and after a while after the meal, heaviness, he is worried about belching with bitterness and increased tone, and in addition, he begins to lose weight.
Signs and symptoms of polyps
The place where the polyp hurts directly in the gallbladder determines the clinical picture, signs, symptoms and treatment of polyps. The most difficult location where the growth is able to attach is the neck or the organ ducts themselves. This situation significantly obstructs the bile duct and causes signs of jaundice. In other places where such growths are located in adults and children, the symptoms are usually not pronounced and blurred.
At the same time, the symptoms of polyps in women are usually somewhat more pronounced. These include:
- Pain that comes with food and remains after finishing the meal.
- Obstructive jaundice.
- Colic in the kidneys or liver.
- Bitter taste, nausea and occasional vomiting.
An outgrowth can hurt in situations where the walls are overstretched with stagnant contents, as well as frequent contractions of the organ. Irritation can be caused not only by stagnant contents, but also by organ receptors. Pain is often triggered by fatty, fried or salty foods, alcohol, and certain medications. Also, the development of the inflammatory process in the gallbladder can cause severe stress.
Icteric manifestations are called staining of the patient’s skin in a yellowish color, especially the mucous membranes. This is manifested as a result of an increase in bilirubin in the blood. It is important to note what color the patient’s skin was when he was healthy. For the owner of fair skin, the pigment changes to a bright yellow color. And in a person with a dark skin tone, it will become a dark orange color. Also, the color change is accompanied by itching and nausea. In addition, when jaundice develops, the urine changes color to a darker one. Fever, pain in muscles and joints may appear.
Colic is a pain that comes and goes suddenly. It is strong, cramping and acute, and usually manifests itself when the outflow of bile is completely disturbed. Disorders of metabolic processes provoke the appearance of a polyp on a long stem, which is otherwise called adenomatous. But in order to determine this type of growths, it is worthwhile at an appointment with a specialist with an ultrasound machine to find a feeding vessel that provokes the formation of a gallbladder polyposis. When hepatic colic is present, signs of inflammation are determined quite simply – the patient is unable to sit exactly during the attack, he is pursued by severe pain that occurs for no reason. This is due to the fact that the organ contracts and involuntarily shrinks either the leg of the polyp or the growth itself.
Other manifestations – bitterness, nausea and vomiting – may be present constantly, intermittently, or absent altogether. It is impossible to determine by these symptoms the presence of a certain formation, ranging from harmless polyposis formations and ending with a malignant tumor of gallbladder cancer. To determine, you will need to perform a number of diagnostic steps, including ultrasound, blood and urine tests, endoscopic examinations, MSCT.
Diagnosis of polyps in the gallbladder
Diagnosis of a disease of the gallbladder polyp is carried out mainly by two methods, which include ultrasound ultrasound and endoscopic ultrasonography.
Ultrasound identifies the gallbladder as a dark oval-shaped spot, the center of which is much lighter. In its normal form, the wall should be flat and free of build-ups, and the color of the cavity should be uniform. The detected polyps look like a lighter spot, if it is a polyp on a pedicle, then both the cap and the pedicle of the formation itself are visualized.
Diagnosis of multiple formations is also reduced to their recalculation and study of their type. The color and echoes of polyps are usually patchy, while cholesterol and inflammatory polyps appear as completely white and uniform lesions.
The second main method for determining the presence of polyps in the body is an endoscopic procedure, which allows you to insert an ultrasound probe into the duodenum. Since this place is located as close as possible to the gallbladder, ultrasound allows you to visualize the organ and all its contents with high accuracy on the screen.
Also, methods for diagnosing polyps include MSCT – multislice computed tomography. It is an additional research method, as it is a rather expensive and complicated method. CT makes it possible to see even the smallest formations in the cavity of the organ, and it is also impossible to damage the tissues of the organ with its help. If it is possible to use a contrast agent, then with its help you can see how much fluid accumulates. It is especially important to conduct such a research method if there is a history of gallstone disease, the patient’s medical history usually confirms this. If during an ultrasound not only a polyp was found, but also a presumptive diagnosis was made, then this is not the time to get upset.
What to do with polyps in the gallbladder
When an ultrasound scan reveals a polyp in the gallbladder, the first thing to do is to start therapy. It is absolutely impossible to ignore this. Growths in the gallbladder of this kind will generally have to be removed surgically. The first step in starting treatment for polyps in the bile is to see a doctor.
Inaction has a detrimental effect on the health of both the adult and the child. New polyps are formed, which will grow into the lumen, filling the entire space and preventing all digestion from working at full strength. If inactive, overgrown growths cause stagnation of bile, turn out to be the basis of biliary cirrhosis and stones. That is why it is necessary to remove or carefully monitor gallbladder polyps. When treating with existing polyps in the gallbladder, a large number of them will be extremely difficult to remove.
Is it possible to cure polyps in the gallbladder without surgery
The first question that arises in a person who has just received the results of an ultrasound is: “Is it possible to cure all polyps of any size in the gallbladder without surgery.” The polyps themselves are not a dangerous formation in the body, but they often disrupt the outflow of bile and worsen the general state of health. It also often happens that it is not possible to stop the growth of a polyp, or it develops into a malignant tumor, treatment without surgery is absolutely impossible.
Cholesterol polyps from 4 mm to 1 cm do not require urgent surgery, only an examination is required once every six months. The best way of examining is CT, which allows you to see all the polyps, down to the smallest. This method allows you to track the entire dynamics of changes in the situation, as well as to make a conclusion – is it possible to treat polyps in the gallbladder without surgery. Experts say that in the gallbladder a polyp, consisting of cholesterol, with a small size, can disappear on its own with the right treatment.
Polycystic disease has an ICD code of 10 K82.8. It is already difficult to answer in the affirmative to the question of whether a polyp can resolve when there are more than one of them. It depends on its size – a 2-3 mm polyp can leave the bladder along with the excreted bile. But this is possible only when the correct drug therapy of these growths is carried out. Only a specialist can tell about how to get rid of gallbladder polyps, whether you have to do an operation. You cannot independently prescribe drugs for yourself and begin treatment, even if the size of the formations does not exceed 2-3 mm. As a result of the emerging complications, the consequences can be unpredictable.
How to treat gallbladder polyposis with pills
With the disease “polyposis of the gallbladder”, the doctor begins treatment with medication only if the formations are small and do not interfere with the satisfactory functioning of the body. It includes in the first stage the intake of certain drugs that ensure the dissolution of formations with the help of ursodeoxycholic and chenodeoxycholic acids. They are found in some drugs. With the help of such drugs, treatment of gallbladder polyps can be quite effective.
Preparations for polyps in the gallbladder, which will be prescribed by the attending physician, will be aimed at relieving pain, symptoms of the disease and normalizing the functioning of the digestive organs.
The answer to the question of how to treat the appeared gallbladder polyposis depends on the type and location of the formations inside the organ. If, under the influence of HPV, papillomas in the gallbladder appear in the body, then the treatment can only be operative, since there is a high risk of degeneration into a cancerous formation. If cholesterol formations have formed, then the treatment of gallbladder polyps begins with taking a drug such as ursofalk. It does an excellent job of dissolving cholesterol deposits in the organ, which is confirmed by patient reviews.
Such polyps in the gallbladder are treated only if they do not grow, do not change their location, do not exceed 1 cm and do not cause serious problems in a person’s well-being. In this case, the patient will have to take the prescribed therapy and appear at least once every 3 months for an ultrasound scan.
Ursosan for polyps in the gallbladder
This drug is prescribed to drink if the gallbladder is functioning, but with malfunctions. It is customary to take it for gallbladder polyps, if the patient has hepatitis, cholestasis and uncomplicated stones in the gallbladder. Ursosan can destroy existing formations and normalize the correct functioning of the organ. It is important that this drug is recommended by a doctor based on available research. You can not self-medicate, as improperly selected therapy can lead to negative consequences.
In what cases is surgery done in the gallbladder for polyps?
Despite the fact that surgical intervention is the main means of combating polyposis, each time a specialist considers the possibility of curing the disease with medication. Multiple polyps are only amenable to surgical treatment of polyps, especially if the size of each of them exceeds a few millimeters. If there is only one neoplasm, but it exceeds 5 mm, an operation must be performed.
Any pathologies of the gallbladder that provoke the appearance of neoplasms in the cavity of the organ do not leave the possibility of drug therapy. In any case, the size of the neoplasm plays an important role, but multiple polyps often lead not only to surgical intervention, but also to the removal of the entire organ. Indications for removal of the gallbladder may be as follows:
- Multiple polyposis.
- One large polyp, especially if it overlaps the lumen of the organ neck.
- A large number of formations in the gallbladder.
- Malignant formation.
The question of whether it is necessary to remove the entire organ with the polyp can only be answered by a doctor after a complete diagnosis. But most often the removal of the gallbladder polyp ends with the preservation of the organ.
The risk of becoming cancer
The size of polyps, which is 6 mm or 7 mm, indicates that there is an adenoma in the gallbladder, which must be removed without fail. First of all, such a formation seriously disrupts the work of not only the gallbladder, but the entire digestive system as a whole. A 9 mm or more of education most often degenerates into a malignant tumor, therefore, immediately after its detection, it is necessary to prepare for surgery.
A formation such as a glandular adenomatous polyp also requires surgical intervention, since conservative treatment in this case will not be effective and causes deformation of the biliary tract. In addition, such a formation can become inflamed or cause tissue necrosis as a result of injury or impaired blood supply. This type of polyps is also easily malignant malignant.
Even a small polyp has a risk of malignancy. That is why in the presence of polyps, it is necessary to be regularly examined and undergo procedures such as ultrasound and CT. This will allow you to track any changes in the growths, as well as the regular delivery of biochemical tests. Even when taking medications and following all the instructions, you need to be prepared for the fact that at some point you will have to remove a polyp or the entire gallbladder at the slightest suspicion that it is becoming a cancerous tumor.
When an unremoved polyp in the gallbladder grows, it completely blocks the existing lumen in the organ. This is what causes acute attacks of incipient hepatic colic. The pain occurs in the right hypochondrium and can spread to any part of the abdomen. The patient cannot eat or sleep, and the painful sensations can last from one to several hours, causing nausea and vomiting, as well as weakness throughout the body. A stone in the liver or gallbladder increases the pain that appears, and the urgent operation shown in this case is greatly complicated by a similar condition of the patient.
Cholecystitis and inflammation
The inflammation, which is provoked by the presence of polyps, gradually turns into purulent cholecystitis, which is a sign of an untimely operation. This is accompanied by a sharp and severe deterioration in human health, the appearance of complications, some of which even lead to death.
Problems with excretion of bile and increased bilirubin
An increase in such a blood indicator as bilirubin is manifested due to stagnation of bile. Typically, this occurs when a polyp interferes with the flow of bile through the ducts. An increase in bilirubin is extremely dangerous for the body, since it is involved in the breakdown of hemoglobin, and also has toxic properties. It is excreted along with bile, therefore, a violation of its normal outflow provokes an increase in it in the blood. An excess amount invariably causes a gradual intoxication of the body.
Types of cholecystectomy
Cholecystectomy for removal of the gallbladder is a procedure that is performed not only with absolute, but also with relative indications. If rehabilitation is carried out by the patient correctly, then the prognosis after it will be quite favorable. The operation is performed by several main methods in the treatment of polyps growing in the gallbladder:
- The classic open intervention is laparotomy.
- Transluminal surgery.
In the treatment of existing polyps in the gallbladder, video laparoscopic surgery is usually used recently. Removal of all polyps of the gallbladder in this case is done through a small incision, which allows you not to leave large scars on the skin and significantly shortens the rehabilitation period. General anesthesia is applied, then several punctures are made in the treated abdomen, through which the entire operation is performed.
When treating with existing polyps in the bile, laparotomy is currently performed only in cases where there is a high probability of death of a person from infection or there is no time for careful intervention. Usually, such operations in the treatment of polyps growing in the gallbladder have recently been carried out only if there is a high risk of death of a person after a rupture or severe trauma to the organ.
During this operation, the gallbladder is separated from the rest of the organs using long-handled instruments under the supervision of a video camera. Thus, doctors see exactly how to act. Anesthesia in this operation is given general, since the muscles must completely relax, and the patient in full consciousness cannot do this.
The surgeon puts clamps on the ducts leading to the organ to prevent bleeding from opening, then cuts it off and removes it. After connecting the ducts and checking for bleeding, the surgeon removes all instruments and sutures the puncture.
Open laparotomy is characterized by greater speed and visibility of the procedure itself, but it is complicated by a longer period of human recovery. It is carried out through a long incision of about 15 centimeters. The doctor pushes the liver away so as not to accidentally touch it in the process. Then the surgeon releases the ducts and vessels from the gallbladder and cuts it off. Sometimes a drainage tube is left in this place for several days. When the doctor is convinced that the operation site is disinfected and there is no infection or suppuration anywhere, the incision is sutured, and the patient is sent to intensive care for several days under round-the-clock observation.
Recovery after surgery
The rehabilitation period begins in the intensive care unit, in which the patient spends from one day to several days, depending on the type of intervention performed. After laparoscopy, the patient can be discharged a day later, and the patient after an open operation will be transferred first to a regular ward, and will be allowed to go home only after a week.
After the organ is removed, pain is considered a normal companion for a while. This will continue until the cured patient gets used to living without him. Pain relievers are prescribed to minimize pain. Also, the site of the incision itself may hurt, usually the painful sensations disappear within 1-2 weeks. In addition, you will have to follow the diet for more than a year.
In order for the recovery to be successful and fast enough, you cannot lift weights for at least a month, avoid physical activity and adhere to fractional nutrition. Food should not be fried or fatty and should be ingested at least 5 times a day. Also, doctors recommend walking in the fresh air as much as possible.
For an accelerated recovery period, doctors recommend doing a few simple physical exercises. They will allow a person to recover faster after surgery. And for those who have not yet undergone the operation – to keep themselves in good shape, and the blood flow in a normal state. With polyps in the initial stage, there are several light exercises that allow you to release the stagnation of bile, but you cannot make them the main method of treatment.
Polyps in the gallbladder do not come on suddenly. Those who have a genetic predisposition to them or to cancers should definitely conduct research on a regular basis. But even if nothing in the body bothers you, you need to undergo an ultrasound of the abdominal cavity at least once a year in order to exclude neoplasms.
A person’s nutrition should be correct, then fat metabolism will not be disturbed. There should also be regular physical activity. In the case of diseases such as gastritis, ulcers, infections and other problems with the gastrointestinal tract, you need to be examined at least twice a year.
Biochemical blood tests also should not be ignored – they can report an increase in bilirubin and show beginning inflammation. Also, doctors advise to get involved in active sports, have an active hobby and spend more time in the fresh air.
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