胆囊良性疾病规范化诊治在胆囊癌防治中的意义

Significance of standardized diagnosis and treatment of benign gallbladder disease in the prevention of gallbladder cancer

胆囊良性疾病与胆囊癌关系密切,公认胆囊结石、胆囊慢性炎症是胆囊癌明确的高危因素,胆囊息肉是否为高危因素仍有争议。我国病人依从性较差,多选择非手术治疗,不能定期复查。多数统计数据提示近年来胆囊癌发病率呈下降趋势,可能与腹腔镜胆囊切除术的普及有关。在胆囊良性疾病治疗选择上,建议外科医生遵循《胆囊良性疾病外科治疗的专家共识(2021版)》,积极手术治疗。胆囊良性疾病规范诊治,在胆囊癌防治中起重要作用,一定程度上可减少胆囊癌的发生。超指南行胆囊切除术治疗胆囊良性疾病,必须权衡手术利弊。

Benign gallbladder diseases are closely related to gallbladder cancer,and it is widely recognized that gallbladder stones and chronic inflammation are risk factors for gallbladder cancer.Whether gallbladder polyps are risk factors is still controversial.Patients in China have poor compliance and often choose non-surgical treatment and delayed follow-up.Most statistical data suggest that the incidence of gallbladder cancer declined in recent years,which may be related to the uptake of laparoscopic cholecystectomy.In selecting treatment for benign gallbladder diseases,it is recommended that surgeons follow the 2021 version of the China expert consensus of surgical treatment for benign gallbladder diseases and actively perform cholecystectomy.Standardized diagnosis and treatment of benign gallbladder diseases play an essential role in preventing gallbladder cancer and may partly reduce the incidence of gallbladder cancer.It is necessary to weigh the advantages and disadvantages of cholecystectomy for benign gallbladder diseases when beyond the indication of guidelines.