Surgical indications of polypoid lesions of the gallbladder: a clinical analysis of 331 cases in Xinjiang Uygur Autonomous Region, China
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摘要:
目的对胆囊息肉样病变(PLG)的临床特征进行分析,并探讨手术切除指征。方法对2008年8月-2013年12月新疆医科大学第四附属医院331例住院已经手术的PLG患者资料进行回顾性分析。组间率的比较采用卡方检验。结果 331例手术病例中,肿瘤性息肉13例(3.9%),非肿瘤性息肉318例(96.2%);将肿瘤组与非肿瘤组的临床特征进行对比,发现性别(χ2=6.2,P=0.013)、年龄(≥40岁/<40岁)(χ2=3.90,P=0.048)、息肉大小(≥10 mm/<10 mm)(χ2=77.4,P<0.000 1)、病灶数目(多发/单发)(χ2=6.2,P=0.013)、息肉基底宽度(≥6 mm/<6 mm)(χ2=111.8,P<0.000 1)、是否合并胆囊结石(χ2=7.5,P=0.006)在2组间分布差异具有统计学意义。结论症状是决定手术指征的一个单独因素,有症状即应手术。大多数胆囊息肉恶变率低,年龄≥40岁、直径≥10 mm的单发息肉、息肉基底宽≥6 mm、近期增大明显、息肉合并结石等肿瘤相关因素,也是胆囊切除的手术指征。
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关键词:
- 胆囊疾病 /
- 息肉 /
- 胆囊切除术 /
- 新疆[维吾尔自治区]
Abstract:Objective To explore the clinical characteristics and surgical indications of polypoid lesions of the gallbladder (PLG) . Methods The clinical data of 331 patients with PLG who underwent surgery in Department of General Surgery from August 2008 to December2013 were analyzed retrospectively. Comparison of ratios between two groups was analyzed by chi- square test. Results Among the 331 surgical cases, there were 13 cases with adenomatous polyps (3. 9%) and 318 cases with non- adenomatous polyps (96. 1%) . After comparing the clinical characteristics of the two groups, significant differences were observed in the following parameters: sex (χ2= 6. 2, P =0. 013) , age (≥40 / < 40) (χ2= 3. 90, P = 0. 048) , sizes of polyps (≥10 mm / < 10 mm) (χ2= 77. 4, P < 0. 000 1) , number of lesions (multiple /solitary) (χ2= 6. 2, P = 0. 013) , PLG basal width (≥6 mm / < 6 mm) ( χ2= 111. 8, P < 0. 000 1) , and presence or absence of concomitant calculi (χ2= 7. 5, P = 0. 006) . Conclusion Clinical symptom is considered an indication for surgery. For most of the gallbladder polyps, the risk of malignant transformation is extremely low. Other surgical indications for gallbladder excision include age≥40 years, single polyps measured ≥10 mm in diameter, polyp basal width ≥6 mm, recent rapid polyp growth, and tumor- associated factors such as polyps with calculi.
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Key words:
- gallbladder diseases /
- polyps /
- cholecystectomy /
- XINJIANG
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