腹腔镜胆囊息肉样病变切除术297例总结

Laparoscopic cholecystectomy in the treatment of polypoid gallbladder:with an analysis of 297 cases

目的:总结腹腔镜下胆囊息肉样病变切除术的经验。方法:为胆囊息肉样病变(PLG)297例实施腹腔镜胆囊切除术。结果:手术成功率100％,无手术并发症,术后平均住院3.7d,病理检查其中5例癌变,3例病变局限在胆囊粘膜,仅切除胆囊,2例病变侵入到粘膜下及肌层,并有肝门淋巴结转移,行胆囊床肝组织部分切除术和肝门淋巴结清扫术,随访3年,有淋巴结转移的2例死亡,余存活。结论:PLG多数是良性疾病,但部分患者潜藏着早期癌和癌前病变,需提高对PLG的认识并选择正确的治疗方式。

Objective:To summarize the experience of laparoscopy cholecystectomy in the treatment of polypoid gallabladder( PLG) .Method:297 cases with PLG were performed laparoscopic cholecystectomy. Result: The successful rate was 100% ,5 cases occured canceration which happened in the mucous coat of gallbladder in 3 cases and happened deep into submucous and muscular layers of mucosa in the other 2 cases with transferring of hepatic portal lymph node, who were undertaken partial resection of gallbladder bed liver tissue and cleaning of hepatic portal lymph node, but died 3 years later. Conclusion: Most of PLG are benign, but some of them conceal canceration. The operators should select correct treatment.