Polyps call abnormally arisen benign outgrowths that have an irregular, teardrop or rounded shape and are localized on the walls of organs with a hollow structure. Usually polypous structures are located on a wide base or are attached to the organ wall by a peculiar pedicle.
Polyps can be located on the mucosa of any organ, however, most often such outgrowths are found in the bile or bladder, intestine, uterus, stomach or nasal cavity. Sometimes polypous lesions appear on the walls of the gallbladder.
Concept of the disease
Polyps of cholesterol-localization are tumorous neoplasms of predominantly benign nature that form on the inner mucous layer of the organ and grow into its lumen.
Photo of the polyp in the gallbladder
According to the international classification of diseases of the polypam of the gallbladder, code K82 belongs( other cholelithiasis pathologies).Polyps with a similar location are difficult to diagnose, because they have a symptomatology similar to other cholelithiasis pathologies.
Species
In the gallbladder, the following varieties of polyps can be found:
- Adenomatous - are considered to be benign tumors. They differ in high risk of malignancy( 10% of cases) and develop as a result of proliferation of glandular tissues. Because of the risk of malignancy, such polyps require constant attention from doctors and compulsory treatment;
- The papillomas are also true benign polyps that have a papilliform shape. They can also be reborn as a malignant tumor;
- Polyps of inflammatory origin - refer to pseudotumens and are a consequence of an inflammatory reaction on the mucous gallbladder shell, as a result of which tissue proliferation takes place. Such polyps are formed due to irritating factors like concrements, parasites, etc.;
- Cholesterol polyps - also belong to the category of false polyps and can dissolve in the process of conservative therapy. But the difficulty is that with ultrasound, they are often mistaken for true polyps. Such formations are cholesterol deposits arising from failures in fat-exchange processes, may contain inclusions of calcium, so they are often mistaken for concrements.
More often than others the cholesterol polyps which give in to conservative therapy are found out.
Causes of
The most common reasons for the formation of polyps in the gallbladder lie in the following factors:
- Substance-related disorders;
- Gallbladder pathologies of inflammatory origin;
- Hereditary predisposition;
- Anomalies of genetic origin;
- Dyskinesia of biliary tract and other hepatobiliary pathologies.
Most often, cholesterol polyps are formed against a background of various kinds of fat metabolism disorders, which cause large amounts of cholesterol to circulate in the bloodstream. As a result, cholesterol excess is deposited on the vascular walls and in the gall bladder, which provokes the formation of cholesterol pseudopolips.
Chronic forms of cholecystitis are considered the most common factors that cause polyposis formation.
Against the backdrop of the inflammatory process in the cholelithoracic tissues, gallstone stagnation occurs, which leads to thickening of the walls of the organ and their deformation. As a result, the cells of the granulation tissue grow, and pseudopolips form.
If the family history is burdened by genetic abnormalities, then this is an additional provoking factor for the emergence of clinical manifestations of pathology.
Hepatobiliary diseases or diseases of the bile ducts provoke an imbalance in the bile secretion and its really necessary volumes.
Owing to excessive or deficient bile secretion, digestive processes are disrupted, which subsequently leads to the formation of cholelithiasis polyposis.
Symptoms of
Symptomatic pattern of polyposis of bile localization is determined by the specific location of the outgrowth in the organ.
The most dangerous from a clinical point of view is the location of the polyp in the cervix or the duct of the bladder.
In a similar situation, the polyp will prevent the normal cholic outflow, which will lead to the development of jaundice of a mechanical nature.
With the location of polypous formation in another part of the bladder, the clinical picture of the pathology becomes blurred and not expressed. Most often for the presence of cholelithiasis polyp indicate such manifestations.
- Jaundice. Skin becomes icteric, as does sclera, which indicates an excessive content of bilirubin in the blood. A similar picture is observed when the gall bladder occurs, leading to leakage of bile into the bloodstream. Complementary to the yellowing of the skin is symptomatology like darkening of urine, myalgia and arthralgia, hyperthermia, nausea-vomiting syndrome and skin itching.
- Soreness. Painful manifestations in cholelithiasis polyps occur due to overstretch of the walls of the organ. This happens when the bile stagnates in the bladder. In addition, pain can occur and against a background of frequent contractions of the bladder. Localized such pain in the right hypochondrium and have a stupid character. They arise cramping, exacerbated after fatty foods or overeating, alcoholic beverages, stress, etc.
- Dyspepsia. It is characterized by the appearance of a nausea syndrome, more often in the morning hours, after a heavy meal, vomiting occurs, and the taste of bitterness is present in the mouth. Similar signs are also caused by bile duct, which provokes a violation of digestion processes. Bitterness in the mouth is explained by the throwing of bile into the stomach due to motor cholelithiasis hyperactivity.
- Colic in the liver. It is manifested by sudden cramping and acute soreness in the area of ​​hypochondrium on the right. Such a sign usually arises quite rarely, mainly with polyps having a long leg. Pain in colic is so strong that the patient is not able to stay in one place, so he rushes, in vain seeking a more painless position of the body.
Concomitant diseases
Quite often polyps cause pathological processes in neighboring organs - pancreas and liver. Since polyposis can act as an infectious source that causes the development of the inflammatory process, against the background of cholelithiasis polyps often develop biliary excrements, cholecystitis, pancreatitis, etc.
In general, among the accompanying polyposis pathologies can be identified spasms of the bile ducts or dyskinesia, a variety of forms of pancreatitis and cholecystitisor cholelithiasis,
Is it a dysfunction?
Gallbladder polyps are dangerous because in the absence of treatment they can easily degenerate into malignant formations, the percentage of such probability is about 10-30%.
In addition, polyps can be complicated by purulent inflammation of the gallbladder, etc. Against the background of constantly elevated bilirubin may develop cerebrospinal intoxication.
Therefore, it is necessary to contact specialists in a timely manner for help and treatment.
Diagnosis of
formation Usually patients turn to specialists when they have the corresponding symptomatology associated with right-sided soreness. But only on this symptom to determine the presence of polyps in the biliary is impossible.
To detect pathology, it is possible only with the help of a more thorough diagnosis using appropriate equipment.
First patients are sent to an ultrasound examination, which is considered to be the leading in detecting the cholelithiasis polyposis.
Computed tomography and magnetic resonance cholangiography are also shown. These techniques allow to determine with the greatest accuracy the location, nature and quality of polyposic formations, as well as to detect the presence of concomitant disorders.
As part of the diagnostic study is often present and endoscopic endosonography, revealing the location and structure of polyposis proliferation.
How to treat polyps in the gallbladder?
Usually after the detection of polypous cholelithiasis, conservative therapy is prescribed. It often happens that with cholesterol polypos after adjusting the diet and taking some medications, cholesterol polyps disappear on their own.
If the formations refer to other species and have a diameter of not more than a centimeter, then they are observed for a while simply being observed. The patient periodically goes to an ultrasound examination, CT or MRI.If the polyps do not show a tendency to grow, they will not be touched.
Treatment of polyp without surgery
As it was specified above, non-surgical treatment of polyposis in the gall bladder is possible only with the cholesteric nature of the formations. When treating such polyps, the most common treatment is the use of drugs such as Ursofalk, Simvastatin, Holiver, Ursosan, and for auxiliary therapy they recommend No-shpu and Gepabene.
Conservative therapy of cholesterol polyps is justified if they do not exceed a centimeter size.
Polyposis may in fact not be cell proliferations, but loose cholesterol concrements, which in the future will cause severe pain attacks.
Operation
The operational approach is shown only in cases when polyps differ in constant growth and multiple character.
In the priority of doctors preservation of the gallbladder, because with his ectomy, digestion will be severely disrupted, and fatty foods will not be absorbed at all.
If polyps are found in the cholelithiasis cavity, the doctor necessarily takes the patient under special control in order to exclude the probable risks of the degeneration of the formation into a malignant tumor process.
In case when the course of traditional treatment did not give the expected effect or polyps grew to large sizes, an operative solution of the problem is shown.
Indications
Absolute indications for rapid removal of polyps are such factors as:
- Large sizes of polyposis overgrowth more than one centimeter;
- Propensity of polyps to rapid growth, manifested by an increase in formations by 2 mm per year;
- Multiple nature of polyposis with predominance of growths having a wide base, but not having a pedicle;
- If polyposis is supplemented by the presence of cholelithiasis;
- With the development of polyposis against a background of chronic inflammation of the gallbladder;
- If you have a family history.
The operation is also necessary in the case of a transformational change in the structure of the polyp in malignant formation, with pronounced hepatic colic, purulent cholecystitis, bile duct disorders, increased bilirubin level.
When can I do without an operation?
If polyps do not grow to the size of centimeters, then there is no need to remove them, however, for prevention, a woman should undergo medical examinations and ultrasound examinations monthly for six months.
If after the lapse of half a year of medication the signs of positive dynamics are absent, then they start operative treatment.
Preparation of
The most common operation to eliminate polyps is cholecystectomy. Such a procedure involves the removal of not only polypous growths, but also cholelithiasis. Such an operation is carried out in the usual or endoscopic way. The latter option is more preferable and is used in 90% of cases.
Before the surgery, the patient undergoes the necessary diagnostic tests, hands over laboratory tests, undergoes ultrasound diagnostics. Before the operation, the patient is given general anesthesia using muscle relaxants to relax the muscle tissue.
The operation itself is performed through 4 punctures for insertion into the abdominal cavity of the instruments and further extraction of the gallbladder.
As a result of such an operation, minimal rehabilitation, minor postoperative pain, low percentage of complications such as adhesive or hernial process, infectious lesions are noted.
Lifestyle after removal of the
polyp After surgery, the patient has to change the habitual diet.
When there is no gallbladder, enzymatic activity is seriously impaired, gastric juice is released in much lower concentrations, and instead of the gall bladder immediately goes to the intestine.
To the body more or less learned to live without a gallbladder, you need at least two years.
The first six months are especially important, requiring the observance of the smallest and most insignificant requirements for the diet:
- Consumed food should be cooked only by cooking or steaming;
- The food needs to be chewed for a long time and thoroughly, so that large pieces do not get into the stomach, which will provide the liver more opportunities for enzymatic activity;
- One meal should eat a small amount of food, so as not to overload the digestive system.
Diet
Both before and after the operation, a diet for polypas of the gallbladder assumes the observance of a fractional diet, when the patient should eat slightly, but every 3 hours. In addition:
- After eating, there should not be a feeling of overeating;
- Food should be eaten in grated or heavily chopped form;
- Eliminate any load for one and a half hours after a meal;
- Cook food only by baking or baking;
- Do not eat food hot.
You can not eat mushroom and fatty soups, buns and fried pies, fatty fish and meat, smoked meats, various mayonnaises and sauces, sour vegetables like tomato, radish, sorrel, etc. Also banned fatty milk products, alcohol and soda, chocolate and so on.
Folk remedies
If the doctor recommended surgical removal of polypous growths of the gallbladder, then get rid of them with the help of folk remedies will never work.
But if the doctor chose surveillance tactics and prescribed conservative therapy, then it is possible to supplement the basic treatment with the intake of herbal medicines, but only if agreed with the doctor.
For additional conservative treatment, you can take infusion from the herb celandine or with the addition of chamomile flowers. The grass is poured with boiling water and kept in a thermos for a couple of hours, after which they drink on a large spoon before food.
These infusions are recommended to take at least a month. Take into account, such treatment can only be an addition to the main one and can not replace it.
Comments of patients about therapy
Elena:
My mother had a long sore under the ribs on the right side. She fell on the liver until she was examined. Bile polyps and a knobby in the bladder were found. Urgent operation, removed the gallstone completely. At first we wanted to do an open surgery, but we insisted on endoscopy. In the early years, my mother kept a strict diet, and now she lives, as usual, after 6 years have passed since the operation.
Maria:
I soon after the birth began to get very sick right on the liver. I went to the ultrasound, where polyps were found. Doctors said that mandatory removal is required, because the sprouting is large and can go to a cancerous tumor. We recommended laparoscopic holicystectomy. The operation was wonderful, doing general anesthesia. Already on the fifth day I was sent home. Almost half a year has already passed. Gradually I start to introduce new products into the diet, because before they were not allowed. While I do not eat smoked food and fried delicacies, although I cook them for my family. But, the main thing is that now my cancer does not threaten me, and dietary requirements and deprivations can easily be endured.
Forecast
Small polyposis growths, which are not prone to increase, differ in favorable predictions and are treated with the use of medications. However, cholelithiasis polyps often develop asymptomatically, and when characteristic manifestations appear, sprouting can reach considerable dimensions or even be malignant.
Therefore, at the first alarming calls it is necessary to pass a survey in order to prevent the development of cancer. Then the forecasts will be extremely positive.
Video operations to remove polyps in the gallbladder: