Csendes A, Burgos A M, Csendes P, Smok G, Rojas J
Department of Surgery, University Hospital, Santiago, Chile.
Ann Surg. 2001 Nov;234(5):657-60. doi: 10.1097/00000658-200111000-00011.
To determine the variation in number, size, and symptoms in patients with polypoid lesions of the gallbladder.
A polypoid lesion is any elevated lesion of the gallbladder mucosa. Several studies have been reported in patients undergoing cholecystectomy, but little information exits regarding the natural history of these lesions in nonoperated patients.
A total of 111 patients with ultrasound diagnosis of polypoid lesions smaller than 10 mm were followed up by clinical evaluation and ultrasonography. Twenty-seven patients underwent cholecystectomy.
There was no difference in terms of gender. Nearly 80% of the lesions were smaller than 5 mm; they were single in 74%. In nonoperated patients, 50% remained of similar size at the late follow-up, 26.5% increased in number and size, and 23.5% shrank or disappeared. Among the operated patients, 70% corresponded to cholesterol polyps. None of the patients developed symptoms of biliary disease or gallstones or adenocarcinoma.
Ultrasound is useful in the follow-up of patients with polypoid lesions of the gallbladder. Lesions smaller than 10 mm do not progress to malignancy or to development of stones, and none produced symptoms or complications of biliary disease.
确定胆囊息肉样病变患者在数量、大小及症状方面的变化。
息肉样病变是指胆囊黏膜的任何隆起性病变。已有多项针对接受胆囊切除术患者的研究报道,但关于这些病变在未接受手术患者中的自然病史的信息却很少。
对111例经超声诊断为息肉样病变且直径小于10 mm的患者进行临床评估及超声检查随访。27例患者接受了胆囊切除术。
在性别方面无差异。近80%的病变小于5 mm;74%为单发。在未接受手术的患者中,50%在随访后期大小保持相似,26.5%数量及大小增加,23.5%缩小或消失。在接受手术的患者中,70%为胆固醇息肉。所有患者均未出现胆道疾病、胆结石或腺癌的症状。
超声对胆囊息肉样病变患者的随访有用。直径小于10 mm的病变不会进展为恶性或发展为结石,且均未产生胆道疾病的症状或并发症。