胆囊息肉样病变204例临床分析

Clinical analysis of 203 oases with polypoid lesions of the gallbladders

目的探讨胆囊息肉样病变（PLG）的临床若干问题，提高其诊断、治疗水平。方法腹部B超检出胆囊息肉样病变患者204例，其中31例经腹腔镜或剖腹胆囊摘除术，对其临床表现与病理特点进行比较。结果31例患者中，有症状者15例，占48．38％，胆囊原位癌1例（3．2％），真性肿瘤6例（19．35％），息肉样病变24例（77．42％），胆囊增厚20例（64．5％），合并结石者6例（19．3％）。结论胆囊息肉样病变属胆囊良性肿瘤，但少数有恶变危险，建议对于下列情况之一均应手术治疗：（1）年龄〉50岁单发性胆囊息肉；（2）单发性胆囊息肉样病变直径≥10mm或多发性的直径≥12mm；（3）直径〈10mm但胆囊壁显著增厚（〉4mm）及（或）伴有结石；（4）有较明显的临床症状内科治疗治疗后症状无缓解；（5）B超动态检查息肉短期增大者应手术治疗。

Objective To investigate the pat hologic and clinical features of the polypoid lesions ofthe gallbladders（PLG）and to improve the diagnosis and therapy .Methods The ultrasonograp hy（US）was performed in 203 cases of PL G.31 of 204 cases were hospitalized and operated, their clinical mani2festations with path ology were compared, Results There were 12 males and 19 females whose agesranged from 28 to 60 years（average age 37 years）.15 of them had evident symptoms（48.38%）.Pathological categoriesc Original cencer in one case; True benign tumors in 6 cases（19.35%）; Polypoid lesions in 24 cases（77.42%）.There were thick wails of the gallbladders in 20 cases（64.5%）; PL G with gallstone in 6 cases（19.3%）.Gondusion A few of PL G have the risk of malignancy though they are benign tumors.Cholecystectomy should be performed in following cases： Age 〉 50years; PL G 10mm or multiple polyps ≥ 12mm in diametel; PL G 〈 10mm but with thick wall of the gallbladder obviously（ 〉 4mm）or with gallstone ; severesymptoms ; and enlargement of PL G in short time.