胆囊息肉样病变手术治疗指征探讨

Surgical Indications of Polypoid Lesion of Gallbladder

【目的】初步探讨胆囊息肉样病变的手术指征。【方法】回顾性分析手术治疗的375例胆囊息肉样病变（PLG）患者的临床与病理资料。【结果】术后病理结果显示恶性危险 PLG 患者28例（7．5％，危险组），无恶性危险 PLG 患者347例（92．5％，无危险组）。对两组患者息肉长径大小、数量、形态、无有合并结石及患者年龄、性别、病程、症状等临床资料进行比较，结果发现，患者年龄≥50岁、合并结石、单发息肉、息肉大于10 mm 、无蒂或宽基和有增大趋势两组间差异均有统计学意义（ P ＜0．05）；而不同性别、有无临床症状则差异无统计学意义（ P ＞0．05）。【结论】绝大多数 PLG 无恶性危险，可随访观察；但对于年龄≥50岁、直径≥10 mm 、单发息肉、无蒂或基底较宽、合并胆囊结石及短期有增大趋势者恶变危险性明显增加，应视为 PLG 的手术指征。

[Objective] To explore the surgical indications of polypoid lesions of gallbladder （PLG ） .[Methods] Retrospective analyses were conducted for clinicopathological data of 375 surgical PLG patients .[Results] Based upon the postoperative pathological results ,the dangerous group （ n = 8 ,7 .5% ） had malig‐nant risk while the non‐dangerous group （ n = 347 ,92 .5% ） had not .The clinical data of size ,number ,mor‐phology ,combined cholecystolithiasis or not ,age ,gender ,disease course and symptoms were compared .Sig‐nificant inter‐group differences （ P 〈 0 .05） existed in age ≥ 50 years old ,size ≥ 10 mm ,concurrent cholecys‐tolithiasis ,solitary polyps ,wide lesion base ,no pedicle and increasing trend .However ,there was no signifi‐cant difference in gender or symptoms （ P 〉 0 .05） .[Conclusion] Most cases of PLG carry no malignant risk and are suitable for follow‐ups .Surgical indications of PLG include age ≥ 50 years old ,lesion size ≥ 10 mm , concurrent cholecystolithiasis ,single polyps ,no pedicle and increasing trend .