胆囊胆固醇结石与胆固醇息肉的关系研究  

Relationship between cholesterol gallstones and cholesterol polyps:a clinical study

作　　者：荣万水[1] 曾庆敏[1] 吴建华[1] 王延召[1] 刘津灵[1] 王云帆[1] 

机构地区：[1]北京大学首钢医院普通外科,北京100144

出　　处：《中国普通外科杂志》2013年第8期1016-1019,共4页China Journal of General Surgery

基　　金：北京市自然科学基金资助项目(7132081);北京市科学技术委员会资助项目(z131107002213103)

摘　　要：目的:探讨胆囊胆固醇结石与胆固醇息肉的关系。方法:抽样调查172例因胆囊结石和胆囊息肉行内镜保胆手术的患者(术后3年以上),其中胆囊结石119例,胆囊息肉39例,胆囊结石合并胆囊息肉14例,观察患者术后结石与息肉的复发情况。结果:119例胆囊结石患者中,术后结石复发22例,无新发息肉;39例胆囊息肉患者中,术后息肉复发3例,新发结石1例;14例胆囊结石合并胆囊息肉患者中,术后息肉复发2例,其中1例并结石复发;胆囊结石与胆囊息肉的复发率差异有统计学意义(P<0.05)。结论:胆囊胆固醇结石与胆固醇息肉可能是发病机制各异的相互独立的疾病,但胆囊息肉可能通过影响胆囊内胆汁流体的状态而影响胆囊胆固醇结石的形成,导致较高的术后复发率,故对合并胆囊息肉的胆囊结石患者不推荐保胆手术。Objective：To investigate the relationship between cholesterol gallstones and cholesterol polyps.Methods：One hundred and seventy-two patients undergoing laparoscopic gallbladder-sparing surgery for gallbladder stones or polyps（more than 3 years after surgery） were selected by sampling.Of them,119 were gallbladder stone patients,39 were gallbladder polyp patients and 14 were gallbladder stone and polyp patients.The postoperative recurrences of stone and polyp of the patients were observed.Results：Of the 119 gallbladder stone patients,postoperative stone recurrence occurred in 24 cases,and no new polyp growth was noted.Of the 39 gallbladder polyp patients,postoperative polyp recurrence occurred in 3 cases and new stone formation was found in one patient.Of the 14 patients with gallbladder stones and polyps,postoperative polyp recurrence occurred in 2 cases,of whom,one case had simultaneous stone recurrence.The difference in recurrence between gallbladder stones and gallbladder polyps had a statistical significance（P＆lt;0.05）.Conclusion：Cholesterol gallstones and cholesterol polyps may be mutually independent diseases of different pathogeneses.However,gallbladder polyps may probably influence cholesterol gallstone formation and cause relatively high postoperative stone recurrence by affecting the liquid state of the bile in the gallbladder,so preservation of the gallbladder is not recommended in surgical management for gallbladder stone patients presenting with gallbladder polyps.

关 键 词：胆囊结石病 胆囊息肉 胆囊切除术 腹腔镜 

分 类 号：R657.4[医药卫生—外科学]