胆囊息肉病外科手术探究.docVIP

胆囊息肉病外科手术探究[摘要]目的 探讨外科胆囊息肉病变的手术与时机。方法 收集我院收治胆囊息肉样病变25例，总结外科手术经验。结果 分析25例胆囊息肉病变，其中良性病变21例，恶性病变4例。结论 对胆囊息肉样病变手术时机选择进行探讨。根据胆囊息肉样病变恶变可能性的高危因素我们提出下列手术指征：（1）单发病变，大于10mm，蒂粗大者，尤其是位于胆囊颈部，年龄大于50岁。（2）多发病变，伴有胆囊结石，有症状，年龄大于50岁。（3）单发病变，小于10mm，无症状，年龄小于50岁，允许观察、随访；病变增大或形态有变化则应手术治疗。（4）多普勒彩超检查病变有丰富血供提示为恶性新生物。（5）CEA（肿瘤标记物），测值明显升高且除外其他胃肠道肿瘤者。（6）胆囊息肉样病变，有明显症状且反复发作者。（7）对直径小于5mm无症状病人应间隔3到5个月随访检查。一旦病变增大或症状明显亦须行手术治疗。(8)患者坚决要求手术治疗者。 关键词：胆囊息肉 胆囊炎 外科手术 Abstract: objective to study the surgical gallbladder polyps lesions operation and opportunity, our method were treated gallbladder polypoid lesion 25 cases, summarizes surgery. Analysis of the results of 25 cases gallbladder disease, including polyps benign lesions 21 patients with m alignant lesions, 4 cases. Conclusions the gallbladder polypoid lesion surgical timing are discussed. According to the gallbladder polypoid lesion high risk factors of the evil change possibility we put forward the following operation indications: (1) more than 10 mm, single lesions, bulky, especially in the’s gallbladder neck, older than 50 years old. (2) of multiple lesions, with cystic and calculous, there are symptoms, older than 50 years old. (3) the pathological changes, less than 10 mm single, asymptomatic, age less than 50 years old, allow observation, follow-up; Or growth of the lesion or form have change should be surgery. (4) doppler color dopplar ultrasound examination lesions are rich blood for tips for m alignant new creatures. (5) the CEA (tumour marker), measured values and other significant increases in except the gastrointestinal tumors. (6) the gallbladder polypoid lesion, have obvious symptoms and repeated the hair. (7) diameter less than 5 mm of asymptomatic patients should be interval 3 to 5 months follow-up inspection. Once or growth of the lesion or symptoms should also go to surgery. (8). Patients insist on the surgical treatment [1]. 中图分类号：R657.1.4 文献标识码：B 文章编号：1004-7484(2011)16-0039-02 1 临床资料 1.1一般资料 男25例，女15例，年龄23～70岁，平均