BACKGROUND: With the wide use of B-ultrasonography in recent years, the polypoid lesion of the gallbladde ( PLG) has been one of the most common diseases detected in biliary surgery. This study was to investigate the ...BACKGROUND: With the wide use of B-ultrasonography in recent years, the polypoid lesion of the gallbladde ( PLG) has been one of the most common diseases detected in biliary surgery. This study was to investigate the diag nostic method and operative indications of PLG. METHODS: The clinical and pathological data of 194 pa tients with PLG who had received operation at our hospita from January 1994 to September 2002 were analyzed retro spectively. Categorized data were analyzed by the chi square test. RESULTS: All the patients received preoperative B-ultra- sonography. 185 of the 194 PLG patients were diagnosed as having cholecystic polyp, and 9 adenomas. Among the 42 patients who received CT, 6 showed early gallbladder can cer. Pathologically, cholesterol polyps were mostly multi ple lesions (64.7%) with a mean diameter of3.86±2.2 mm in 136 patients. Of 16 patients with adenomas, 10 had a tumor diameter of more than 10 mm (62.5%). In 11 pa tients with gallbladder carcinoma, 7 were accompanied with gallbladder stone (63.6%). In addition, inflammatory polyps and adenomyomas were found in 25 and 6 patients respectively. CONCLUSIONS: B-ultrasonography is the most effective diagnostic method for detecting PLG. When large or irreg- ular lesions are found, CT should be performed in order to avoid missing of gallbladder carcinoma. Operative indica- tions for PLG include; a maximal tumor diameter of more than 10 mm; an over 50-year-old patient with a wide-base and a single polyp lesion; a wide-base lesion or a lesion showing a tendency to enlargement; co-existing gallbladder stone or cholecystitis; a patient without other diseases but obvious clinical features and failure of general ma- nagement ; big or long pedicels or polyps at the neck of the gallbladder for preventing the empty of the gallbladder and a history of biliary colic; and PLG with irregularly thick- ened local gallbladder wall.展开更多
文摘BACKGROUND: With the wide use of B-ultrasonography in recent years, the polypoid lesion of the gallbladde ( PLG) has been one of the most common diseases detected in biliary surgery. This study was to investigate the diag nostic method and operative indications of PLG. METHODS: The clinical and pathological data of 194 pa tients with PLG who had received operation at our hospita from January 1994 to September 2002 were analyzed retro spectively. Categorized data were analyzed by the chi square test. RESULTS: All the patients received preoperative B-ultra- sonography. 185 of the 194 PLG patients were diagnosed as having cholecystic polyp, and 9 adenomas. Among the 42 patients who received CT, 6 showed early gallbladder can cer. Pathologically, cholesterol polyps were mostly multi ple lesions (64.7%) with a mean diameter of3.86±2.2 mm in 136 patients. Of 16 patients with adenomas, 10 had a tumor diameter of more than 10 mm (62.5%). In 11 pa tients with gallbladder carcinoma, 7 were accompanied with gallbladder stone (63.6%). In addition, inflammatory polyps and adenomyomas were found in 25 and 6 patients respectively. CONCLUSIONS: B-ultrasonography is the most effective diagnostic method for detecting PLG. When large or irreg- ular lesions are found, CT should be performed in order to avoid missing of gallbladder carcinoma. Operative indica- tions for PLG include; a maximal tumor diameter of more than 10 mm; an over 50-year-old patient with a wide-base and a single polyp lesion; a wide-base lesion or a lesion showing a tendency to enlargement; co-existing gallbladder stone or cholecystitis; a patient without other diseases but obvious clinical features and failure of general ma- nagement ; big or long pedicels or polyps at the neck of the gallbladder for preventing the empty of the gallbladder and a history of biliary colic; and PLG with irregularly thick- ened local gallbladder wall.
