论文部分内容阅读
本文报告胆囊息肉样病变(PLG)98例,占同期手术切除胆囊893例的10.9％。经病理形态观察,按病变成份和性质PLA可分肿瘤性病变和非肿瘤性增生性病变两大类。前者包括良性肿瘤和恶性肿瘤,共17例,其中良性9例,恶性8例;后者多见,共81例,占本组82.7％,其中最常见的是胆固醇性息肉和炎性息肉,均无恶性倾向。而腺瘤和腺瘤样增生可引起恶变,应引起临床注意。上述大体形态可通过B超等影像学手段在术前得到观察。本组见7例炎性假瘤,因体积较大,基底宽,与周围界限不清在术前、术中均易与恶性肿瘤相混,常需在手术中通过快速病理检验做出正确诊断,在临床上应引起重视。经病理临床分析,就PLA的手术指征,本文认为符合下列条件之一时应积极考虑手术:1、息肉直径>1.5cm;2、息肉基底部宽、短期复查不缩小甚至增大;3、伴有胆囊结石及临床症状;4、年龄50岁以上,息肉直径>1.0cm。
This article reports 98 cases of gallbladder polypoid lesions (PLG), accounting for 10.9% of 893 cases of gallbladder surgery. By pathological observation, according to the composition and nature of the disease PLA can be divided into two categories of tumor lesions and non-neoplastic hyperplastic lesions. The former includes benign and malignant tumors, a total of 17 cases, including 9 cases of benign, 8 cases of malignant; the latter more common, a total of 81 cases, accounting for 82.7% of the group, the most common are cholesterol polyps and inflammatory polyps, are No malignant tendency. Adenomas and adenomatous hyperplasia can cause malignant transformation and should cause clinical attention. The above general morphology can be observed before surgery by B-mode ultrasonography. This group saw 7 cases of inflammatory pseudotumor, due to the large size, wide base, and the surrounding boundaries are unclear in the preoperative and intraoperative are easy to mix with malignant tumors, often need to make a correct diagnosis through rapid pathological examination during surgery Clinical attention should be paid. After pathological clinical analysis, on the PLA surgical indication, this article believes that one of the following conditions should be actively considered when surgery: 1, polyps diameter> 1.5cm; 2, polyps basement wide, short-term review does not reduce or even increase; Gallstones and clinical symptoms; 4, age 50 years old, polyps diameter> 1.0cm.