Wan Y L
Zhonghua Wai Ke Za Zhi. 1989 Aug;27(8):450-3, 507.
26 cases of polypoid lesions of the gallbladder are reported. 19 were benign lesions, among them, there were 12 (63%) cholesterol polyp, 4 adenoma, 1 inflammatory polyp, and 2 others. 95% of benign lesions were less than 1 cm in diameter, 63% of which were less than 0.5 cm in diameter, 15 cases were multiple lesions; all cases were not associated with gallstones. 7 cases were carcinoma of the gallbladder, of which, 5 were more than 1 cm in diameter, 2 were less than 1 cm which were carcinoma in situs; 3 were associated with gallstones. The accuracy of preoperative diagnosis of polypoid lesions of the gallbladder made by B-mode ultrasonography, cholecystography, CT, endoscopic ultrasonography were 84%, 53%, 80% and 75% respectively. It is concluded that preoperative diagnosis of polypoid lesions on the gallbladder mainly depends on the B-mode ultrasonography; the lesions less than 0.5 cm in diameter should not be treated by operation for the time being; the lesions between 0.5-1 cm should be followed up by B-mode ultrasonography; the operation may be considered if stones present; the lesions more than 1 cm should be resected since malignancy could not be excluded.
报告了26例胆囊息肉样病变。19例为良性病变,其中胆固醇息肉12例(63%),腺瘤4例,炎性息肉1例,其他2例。95%的良性病变直径小于1cm,其中63%直径小于0.5cm,15例为多发病变;所有病例均未合并胆结石。7例为胆囊癌,其中5例直径大于1cm,2例原位癌直径小于1cm;3例合并胆结石。B超、胆囊造影、CT、内镜超声对胆囊息肉样病变术前诊断的准确率分别为84%、53%、80%和75%。结论:胆囊息肉样病变术前诊断主要依靠B超;直径小于0.5cm的病变暂不手术治疗;直径0.5 - 1cm的病变应行B超随访,如有结石可考虑手术;直径大于1cm的病变因不能排除恶性应行切除。