胆囊息肉样病变的外科治疗体会(附234例报告)  

SURGICAL TREATMENT OF GALLBLADDER POLYPOID LESION

作　　者：庄志祥[1] 尹华[1] 赵中辛[1] 

机构地区：[1]上海市东方医院普外科,上海200120

出　　处：《肝胆外科杂志》2002年第3期208-209,共2页Journal of Hepatobiliary Surgery

摘　　要：目的　探讨胆囊息肉样病变 (GPL)的诊断及手术指手征。方法　对 B超和 (或 )病理诊断的胆囊息肉样病变 2 34例进行回顾性分析。结果　胆固醇性息肉病变表现为多发性 (87.5 % ) ,平均直径 <5 m m,肿瘤性息肉 (腺瘤 ,癌 ,腺肌瘤 )倾向于单发 ,直径在 5 mm- 35 mm。 1例腺瘤伴有粘膜上皮的不典型增生。结论　 (1) B超是诊断 GPL 的最有效方法。 (2 )单发 ,年龄>5 0岁 ,直径 >10 m m或合并胆结石 ,出现相应并发征的 GPL 应行外科手术治疗。 (3)有明显临床症状者 ,经内科正规治疗无效且症状影响工作 ,生活者可考虑手术治疗。(4)对无症状 ,肿块直径 <5 mm者 ,可随访 B超进行定期观察 ,发现病变有增大趋势 。Objective To investigate the diagnosis and treatment of gallbladder polyp lesion(GPL).Methods 234 cases of GPL confirmed by pathological examination were analyzed retrospectively.Results Cholesterol GPL were mostly of multiple foci(87.5%) with a mean diameter of <5mm.Turmoral polyps which included adenomas,carcinoma,adenomyonomas were presented of single focus.Conclusion ①B model ultrasonic examination was the most effective diagnosis method.②The patients older than 50 years with a single polyp lesion or complicated with gallbladder stone,pancreatitis,choledochal bleeding and choledochal fistula should be operated.③The patients with obvious clinical symptoms,who had had a formal internal medical treatment but without any effective should be considered to have a surgical intervention.④The patients without any symptems and with the GPL<5mm in diameter should be followed up closely,if the lesion presented an intention of enlargement,the surgical intervention should be taken in count.

关 键 词：胆囊息肉 诊断 外科治疗 

分 类 号：R657.4[医药卫生—外科学]