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胆囊息肉样病变行腹腔镜胆囊切除术后诊断为胆囊胆固醇息肉的术前预测因素。

Preoperative predictive factors for gallbladder cholesterol polyp diagnosed after laparoscopic cholecystectomy for polypoid lesions of gallbladder.

作者信息

Lee Hyojin, Kim Kihwan, Park Inseok, Cho Hyunjin, Gwak Geumhee, Yang Keunho, Bae Byung-Noe, Kim Hong-Ju, Kim Young Duk

机构信息

Department of Surgery, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea.

出版信息

Ann Hepatobiliary Pancreat Surg. 2016 Nov;20(4):180-186. doi: 10.14701/ahbps.2016.20.4.180. Epub 2016 Nov 30.

DOI:10.14701/ahbps.2016.20.4.180
PMID:28261697
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5325147/
Abstract

BACKGROUNDS/AIMS: We investigated patients' clinical and radiological data to determine preoperative factors that predict cholesterol gallbladder (GB) polyps of large size, which can be helpful for decision on further diagnostic tools.

METHODS

In this study, we retrospectively analyzed 126 patients who underwent laparoscopic cholecystectomy for GB polyps >10 mm diagnosed preoperatively by abdominal ultrasonography between February 2002 and February 2016 in Department of Surgery, Sanggye Paik Hospital. Patients were divided into non-cholesterol polyps group and cholesterol polyps group, based on the postoperative pathologic diagnosis. Clinical and radiological data, such as gender, age, body weight, height, body mass index (BMI), laboratory findings, size, number and shape of the polypoid lesions, and presence of the concurrent GB stone were compared between the two groups.

RESULTS

Of the 126 cases, 73 had cholesterol polyps (57.9%) and 53 cases were non-cholesterol polyps (42.1%). The younger age (<48.5 years), size of polyp <13.25 mm and multiple polyps were independent predictive variables for cholesterol polyps, with odd ratios (OR) of 2.352 (=0.045), 5.429 (<0.001) and 0.472 (<0.001), respectively.

CONCLUSIONS

Age, size and polyp number were used to predict cholesterol GB polyp among polypoid lesions of the gallbladder >10 mm. For cases in which these factors are not applicable, it is strongly recommended to evaluate further diagnostic tools, such as computed tomography, endoscopic ultrasonography and tumor markers.

摘要

背景/目的:我们研究了患者的临床和放射学数据,以确定预测大尺寸胆固醇性胆囊息肉的术前因素,这有助于决定进一步的诊断工具。

方法

在本研究中,我们回顾性分析了2002年2月至2016年2月期间在成均馆大学三星医疗中心外科接受腹腔镜胆囊切除术的126例患者,这些患者术前经腹部超声诊断为胆囊息肉大于10mm。根据术后病理诊断,将患者分为非胆固醇息肉组和胆固醇息肉组。比较两组患者的临床和放射学数据,如性别、年龄、体重、身高、体重指数(BMI)、实验室检查结果、息肉样病变的大小、数量和形状,以及是否合并胆囊结石。

结果

126例患者中,73例为胆固醇息肉(57.9%),53例为非胆固醇息肉(42.1%)。年龄较小(<48.5岁)、息肉大小<13.25mm和多发息肉是胆固醇息肉的独立预测变量,其比值比(OR)分别为2.352(=0.045)、5.429(<0.001)和0.472(<0.001)。

结论

年龄、大小和息肉数量可用于预测胆囊息肉样病变中大于10mm的胆固醇性胆囊息肉。对于这些因素不适用的病例,强烈建议评估进一步的诊断工具,如计算机断层扫描、内镜超声和肿瘤标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc1d/5325147/f4ddc8b2b70e/ahbps-20-180-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc1d/5325147/1e08f47c29c4/ahbps-20-180-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc1d/5325147/3efaf1c15471/ahbps-20-180-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc1d/5325147/f4ddc8b2b70e/ahbps-20-180-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc1d/5325147/1e08f47c29c4/ahbps-20-180-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc1d/5325147/3efaf1c15471/ahbps-20-180-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc1d/5325147/f4ddc8b2b70e/ahbps-20-180-g003.jpg

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本文引用的文献

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Ultrasound follow-up for gallbladder polyps less than 6 mm may not be necessary.对于小于6毫米的胆囊息肉,可能无需进行超声随访。
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Gallbladder polyps: how should they be treated and when?胆囊息肉:应如何治疗以及何时治疗?
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