单纯胆囊息肉样病变56例临床分析

Analysis of simple polypoid lesions of the gallbladder：A report of 56 cases

目的探讨不合并结石的单纯胆囊息肉样病变的诊断及手术指征。方法对我院经B超和病理诊断为胆囊息肉样病变的56例患者进行分析和总结。结果胆囊息肉样病变患者相对年轻（平均39．6yr），临床表现以右上腹隐痛为主（85．0％），病理类型以胆固醇息肉最多（67．9％）。结论胆囊息肉样病变临床表现无特异性。临床诊断以B超为首选，多发性胆固醇息肉多见。单发、年龄〉50yr、直径〉10mm则应手术治疗。有明显临床症状、经正规内科诊断及治疗无效者，可考虑手术。无症状者可行B超随访检查，发现病变有增大趋势可外科手术治疗。

Aim To analyze and summarize diagnostic characteristics of simple polypiid lesions of ganhladder and to determine which polyps of ganhladder should be operated on. Methods We analyzed and summarized 56 gallhladders with polypoid lesions which were diagnosed by Bultrasonography and plthologic examination. Results The patients of polypoid lesions of gallhladder were relatively young（average 39.6 yr）. The typical clinical characteristics were the pain of fight-up abdomen（85.0% ）. Cholesterol poly was the most contain pathological type （67.9%）. Conclusion There is no specific clinical manifestation of polypoid lesions of ganhladder. B-ultrasonngraphy is the best diagnostic method. Surgical operation should be performed if the small polypoid lesions are complicated with cholelithiasis or the patients with solitary small polypoid lesions （diameter 〉 10 mm） are over 50 years old. Polypoid lesions of gallhadder with severe clinical symptoms and insensitive to medical treatment should also be operated on. Besides, asymptomatic but growing polypoid lesions of ganhladder should receive surgical treatment too.