Polypoid lesions of the gallbladder: report of 160 cases with special reference to diagnosis and treatment in China.
Polypoid lesions of the gallbladder: report of 160 cases with special reference to diagnosis and treatment in China.
复制标题
我国胆囊息肉样病变160例诊治特例报告.
DOI：
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发表时间：
2015
影响因子：
1.4
通讯作者：
Zhongwen Zhou
中科院分区：
文献类型：
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作者：
Jingjing Guo;Gang Wu;Zhongwen Zhou
背景
胆囊息肉样病变的术前诊断是困难的，证明缺乏共识的适当治疗。
目的
本研究的目的是确定每种类型的胆囊息肉样病变的特点和手术指征。
方法
在1999年1月至2012年12月期间，回顾性分析了160例接受胆囊切除术患者的临床数据与息肉样病变的组织病理学特征。
结果
良性息肉样病变160例（瘤样病变49例，腺瘤75例），恶性息肉样病变14例（腺癌2例，腺瘤恶变12例）。105例（65.6%）患者有相关症状，70例（43.8%）有胆结石。在49例肿瘤样病变中，49例（100%）与慢性胆囊炎相关。共有72例（83.8%）肿瘤患者有一个单一的息肉相比，25例（59.5%）的非肿瘤性息肉。恶性肿瘤患者的平均年龄为59.07 ± 13.465岁，其中12例（85.7%）患者年龄超过50岁。良、恶性息肉的平均直径分别为1.0 ± 0.77cm和2.15 ± 1.16cm。10例（100%）恶性肿瘤患者的息肉大小超过1 cm，如超声所示。
结论
我们的研究结果表明，肿瘤样病变，腺瘤和腺癌是最常见的息肉样病变的胆囊。有症状者应行胆囊切除术。年龄超过50岁的患者、息肉直径大于10 mm的患者和单发息肉样病变的患者发生恶性肿瘤的风险较高。其余未行胆囊切除术的PLG患者应定期随访。
BACKGROUND
The preoperative diagnosis of gallbladder polypoid lesions is difficult, justifying the lack of consensus on the appropriate treatment.
OBJECTIVE
The aim of this study was to identify the characteristics of each type of polypoid lesion of the gallbladder and the indications for surgery.
METHODS
Between January 1999 and December 2012, clinical data were retrospectively correlated with the histopathologic characteristics of polypoid lesions in 160 patients who underwent cholecystectomy.
RESULTS
A total of 160 patients with benign polypoid lesions (including 49 tumor-like lesions and 75 adenomas) and 14 patients with malignant polypoid lesions (including 2 adenocarcinomas and 12 adenomas with malignant changes) were included in this study. One hundred and five (65.6%) of the patients had associated symptoms, and 70 (43.8%) had gallstones. Of the 49 patients with tumor-like lesions, 49 (100%) were correlated with chronic cholecystitis. A total of 72 (83.8%) patients with neoplasms had a single polyp compared with 25 (59.5%) of those with non-neoplastic polyps. The mean age of the patients with malignancy was 59.07 ± 13.465 years, and 12 (85.7%) of these patients were over 50 years of age. The mean diameters of the benign and malignant polyps were 1.0 ± 0.77 cm and 2.15 ± 1.16 cm, respectively. Ten (100%) of the patients with malignancy had polyps of over 1 cm in size, as shown by ultrasound.
CONCLUSION
Our findings indicate that tumor-like lesions, adenomas, and adenocarcinomas are the most common polypoid lesions of the gallbladder. Cholecystecomy should be done in patients with symptoms. The risk of malignancy is high in patients over 50 years of age; those with polyps with diameters of greater than 10 mm; and those with single polypoid lesions. The remainder of PLG patients without cholecystectomy should be followed up at regular intervals.