胆囊息肉样病变的处理

摘要

目的 讨论胆囊息肉样病变(GPL)的诊断和处理.方法 回顾性分析2002年至2011年10年间经超声检查处理的GPL病例.结果 使用腹部超声检查方法确认GPL共591例,其中349例为女性,占59.1％；年龄范围20～73岁.有395例出现腹痛等症状,39.9％是单发息肉,9.8％同存胆囊结石.使用超声检查GPL的特异性为92.5％.136例使用腹腔镜胆囊切除术,对涉及胆囊癌的病例拟施行开腹胆囊扫除术.结论 多数小的GPL为良性,可静止多年.但具有年龄＞50岁,息肉直径＞10 mm的这两条主要危险因素的患者,应预测可能为恶变的GPL.其余恶变的危险因素尚有同存胆囊结石、单发性息肉、有临床症状的息肉等.%Objective To discuss the diagnosis method and management of Gallbladder polypoeid lesions (GPL).Method A ten-year (2002-2011) retrospective reviews of all patients result underwent in ultrosenography (US) was conducted.Results Total 591 peatients with GPL detected on US were identified,349 patients (59.1％) were women,the age ranges 20 to 93 years.395 patients had abdominal symtoms,of which 39.9％ patients had a single polyp and 9.8％ had gallstones.The specifisity of the diagnosis of GPL in US was 92.5 ％.Laparascopic cholecystectomy (LC) is the treatment of 136 chosen cases.In cases suspicious of malignancy,it is advisable to do cholecystectomy.Conclusions Most small GPL are benign and remain static for years.Age more than 50 years old and size of polyp more than 10 mm are the two main important risk factors predicting malignancy in GPL.Other risk factors include concurrent gallstones,solitary polyp,and symptomatic polyp.LC is the treatment of unless since the suspicion of malignancy is high.