胆囊息肉样病变的诊断与手术指征（附288例报告）

Diagnosis and opeativ.indications for pdypoic lesionsoc the gallbladder: Report of 288 cases.

本文分析经Ｂ超和／或病理诊断的胆囊息肉样病变（ＰＬＧ）２８８例．其中肉眼观证实ＰＬＧ２７４例，良性病变２５６例，以胆固醇性息肉占多数，恶性病变１８例．ＰＬＧ的Ｂ超检出率为９２．７％，Ｂ超诊断ＰＬＧ的特异性达９４．８％．作者认为，Ｂ超是诊断ＰＬＧ的简便可靠的检查方法，且具有较高的临床诊断价值．ＰＬＧ的手术指征：①直径大于１．０ｃｍ的ＰＬＧ，②单发ＰＬＧ，③年龄５０岁以上的ＰＬＧ病人，④合并胆囊结石的ＰＬＧ．直径大于１．５ｃｍ的ＰＬＧ应视为绝对手术指征．

84 patients with an ultrasonograpbic and/or patho-logical diagnosis of polypoid lesions of the gallbladder(PLG) were reviewed to determine the reliability ofultrasonograghy in the diagnosis of PLG and the indi-cations for operation in this disease. Of the 288 pa-tients operated on. PLG were demonstrated by thegross appearance of the resected gallbladder in 274.Histologically benign lesions were present in 256 gall-bladders. and malignant lesions in 18. Cholesterolpolyps accounted for most benign PLG. The sensitivityof ultrasonography in detecting PLG was 92. 7 persent. and the specificity of ultrasonography in diagnos-ing PLG was up to 94. 8 per cent. Therefore. ultra-sonography is a high sensitive method for investigatingPLG. and the preoperative diagnosis of PLG has nowbecome entirely dependent on this technique. Indica-tions for surgery for PLG should be: OPLG exceeding1. 0cm in diameter. PLG being single in number. patients with PLG over 50 years of age. andPLG as-sociated with gallstones. Operation should be absolute-ly performed as soon as PLG exceeding 1. 5cm in diam-eter are recognized.