胆囊息肉临床诊治的新进展

A review on clinical diagnosing and treating gallbladder polyps

近几年胆囊息肉样病变(PLG)已成为胆道外科的常见疾病;B超等影像学技术的发展使PLG的检出率很高。临床上针对PLG的处理方式主要是手术治疗,在手术前明确PLG的类型,确切分清有无恶变倾向的PLG,可以避免实施不必要的预防性胆囊切除术。随着中医药的发展,中药治疗PLG逐渐地得到了重视,发现中药的治疗起到了很好的疗效,尤其是不超过10mm的PLG,有待于我们进一步的研究。本文将对PLG的确诊方法及PLG与恶变关系及中药治疗PLG进行综述,以便确定预防性胆囊切除的手术指征及临床意义。

In recent years, the polypoid lesion of the gallbladder has become a common disease in biliary tract surgery; the development of ultrasound imaging technology makes high the PLG detection rate. Surgery is the major clinical method for treating PLG. Before the surgery, it is necessary to clarify the type of PLG, to distinguish whether there is evil change tendency of PLG or not; it can avoid unnecessary preventive cholecystectomy. TCM medicine gains gradually recognition and achieves great curative effect,especially in treating PLG less than 10 mm; the effect requires our further research. In this paper, the method of diagnosis of PLG, relationship between PGL and malignant transformation and TCM medicine are reviewed, in order to determine the preventive surgical indications and clinical significance of gallbladder excision.