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目的:探讨胆囊息肉的手术指征。方法:统计分析2004年01月-2008年12月间因胆囊息肉而手术病例的病理资料,通过病理类型的分布规律及大小,探求手术指征的安全标准。结果:共316例患者入组,7例胆囊癌病例中,直径均大于1.5CM,良性息肉直径在0.3-1.7CM之间,平均0.82CM。阴性病理结果占8%,良性病变占89.8%,恶性者2.2%。其中胆固醇息肉72%,腺瘤3%,炎性增生14.8%。结论:控制胆囊息肉手术指征放宽的趋势,小于1.2CM的胆囊息肉建议随诊,1.2-1.5CM者,仍可采取密切随诊的措施。大于1.5CM者,采取手术治疗,有术中快速病理的腹腔镜胆囊切除术是安全的。
Objective: To investigate the surgical indication of gallbladder polyps. Methods: The clinical data of patients with gallbladder polyps from January 2004 to December 2008 were statistically analyzed, and the safety criteria of surgical indications were explored through the distribution and size of pathological types. Results: A total of 316 patients were enrolled in this study. Of the 7 cases with gallbladder carcinoma, the diameters were larger than 1.5 cm and the diameter of benign polyps was between 0.3 and 1.7 cm with an average of 0.82 cm. Negative pathological findings accounted for 8%, benign lesions accounted for 89.8%, malignant 2.2%. 72% of which cholesterol polyps, adenoma 3%, 14.8% of inflammatory hyperplasia. Conclusion: The control of gallbladder polyposis indications to relax the trend of less than 1.2CM of gallbladder polyps recommended follow-up, 1.2-1.5CM who can still take close follow-up measures. More than 1.5CM those who take surgical treatment, intraoperative rapid pathology of laparoscopic cholecystectomy is safe.