胆囊腺肌增生症行保胆治疗的研究  

Approach of treating gallbladder adenomyomatosis with preservation of cholecyst

作　　者：吴连宝[1] 胡海[1] 蔡景理[1] 黄安华[1] 徐安安[1] 李海东[1] 何川琦[1] 丁侃[1] 陆瑞祺[1] 叶芮琪[1] 赵刚[1] 

机构地区：[1]同济大学附属上海市东方医院胆石病外科,上海200120

出　　处：《中华腔镜外科杂志（电子版）》2015年第6期27-30,共4页Chinese Journal of Laparoscopic Surgery(Electronic Edition)

摘　　要：目的探讨不同类型胆囊腺肌增生症（GBA）采取腹腔镜保胆治疗的适应证。方法回顾性分析2013年1月至2014年12月,同济大学附属上海市东方医院胆石病专科收治的820例术后病理诊断为GBA的患者临床资料。结果男性351例,女性469例,年龄18~92岁,中位年龄53岁。其中406例局限型GBA（位于胆囊体部、底部）的患者采取腹腔镜胆囊局部切除术,术后无出血、胆漏、切口感染等并发症发生。术后3~24个月随访B超检查未发现GBA复发。局限型（位于胆囊颈部）、节段型和弥漫型GBA均行腹腔镜胆囊切除术,术后恢复良好。结论腹腔镜联合纤维胆道镜行胆囊部分切除手术治疗局限型GBA（位于胆囊体部、底部）,术后随访结果良好,是一种可行的治疗方式。Objective To investigate indications of treating the different types of gallbladder adenomyomatosis（ GBA ）for preservation of cholecyst. Methods The clinical data of 820 patients who underwent surgery for GBA at Dongfang Hospital between Jan. 2013 and Dec. 2014 patients were retrospectively analyzed. Results There were 351 males and 469 females, aged from 18 to 92 years old, the median age of 53. A Total of 406 GBA local on body/fundal part underwent preservation of cholecyst and there were no biliary leaksbleeding and infection in all patients. Postoperative recovery was good follow-up 3- 24 months and ultrasound found no GBA recovery. Fundal type（ local on-neck of gallbladder）, segmental type and diffuse type GBA were performed laparoscopic cholecystectomy, recovering well after surgery. Conclusions The method of preservation of cholecyst with biliary contractibility of GBA using laparoscopy and choledochscopyis a safe and efficient surgical approach. It＇s worth to be popularized and applied.

关 键 词：腹腔镜 胆囊腺肌增生症 保胆治疗 

分 类 号：R657.4[医药卫生—外科学]