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胆囊息肉样病变109例分析 |
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吴金生 何显力 高德明 马庆久 付京
【摘 要】 目的 探讨胆囊息肉样病变(PLG)的诊断及手术指征。方法 对B超和(或)病理诊断的胆囊息肉样病变109例进行了回顾性分析。结果 胆固醇性息肉、腺瘤平均直径分别为(3.69±2.26)mm、(8.0±3.31)mm；97.7%的胆固醇性息肉直径<10mm；肿瘤性息肉(腺瘤)倾向于单发(腺瘤n=1.57±0.9)，而超过50%的胆固醇性息肉表现为多发(n=3.89±3.91)；1例腺瘤伴有粘膜上皮的不典型增生。结论 ①B超是诊断PLG的最有效方法。②单发、年龄>50岁、直径>10mm，或合并胆石的PLG应行外科手术治疗。③有明显临床症状者，须首先经过正规的内科治疗，无效且症状影响工作、生活者可考虑手术治疗。④内科治疗后症状缓解或无临床症状者，可通过B超进行定期观察(3～6个月)，发现病变有增大趋势者可采取外科治疗。
【关键词】 胆囊息肉/诊断 胆囊息肉/治疗 外科
Analysis of 109 cases of polypoid lesions of the gallbladder
Wu Jinsheng,He Xianli,Gao Deming
(Department of General Surgery,Tangdu Hospital of the Fourth Military Medical University,Xi'an 710038)
【Abstract】 Objective To determine which polyps of the gallbladder should be operated on and what means should be used in its diagnosis.Methods We studied 109 resected gallbladders with polypoid lesions which were diagnosed by B-ultrasonography and/or pathologic examination.The polyps in resected gallbladders were classified into 4 groups histologically,and the clinical features,the maximum diameter,and the number of lesions were compared among the groups.The positive rates of diagnosis using different methods were compared.Results The mean diameter of cholesterol polyps was 3.69±2.26mm,and that of adenoma was 8.0±3.31mm;97.7% of cholesterol polyps were less than 10mm in diameter.Neoplastic polyps tended to be single(adenoma,n=1.57±0.9),whereas more than half of the cholesterol polyps were multiple(n=3.89±3.91).Atypical hyperplasia was found in 1 case of adenoma.Conclusion B-ultrasonography is the most effective method in the diagnosis of PLG.Surgical operation should be performed if the small polypoid lesions are complicated with cholelithiasis or the patients with solitary small polypoid lesions(diameter>10mm)are over 50 years old.And the PLG with severe clinical symptoms and insensitive to medical treatment should also be op[1] [2] [3] 下一页
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