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上消化道疾病:胆囊疾病。

Upper Gastrointestinal Conditions: Gallbladder Conditions.

作者信息

Chang Ku-Lang, Estores David S

机构信息

University of Florida Department of Community of Health and Family Medicine, 1600 SW Archer Road Suite N107, Gainesville, FL 32610-3001.

University of Florida Department of Medicine Division of Gastroenterology Hepatology and Nutrition, PO Box 100214, Gainesville, FL 32610-0214.

出版信息

FP Essent. 2017 Jul;458:33-38.

Abstract

Asymptomatic patients with gallstones typically do not require treatment. Surgical intervention is indicated in most symptomatic patients with gallstones. For patients with uncomplicated cholecystitis, laparoscopic cholecystectomy performed within 24 hours of admission is associated with significantly decreased morbidity, hospital length of stay, and cost. Most gallbladder polyps are found incidentally during ultrasonography. Patients with gallbladder polyps are at increased risk of malignant transformation if they are older than 50 years; the gallbladder wall is thickened; or the polyp is adenomatous, solitary, larger than 10 mm, sessile in appearance, or has a rapid increase in size. It is crucial but sometimes difficult to differentiate between benign and malignant polyps using transabdominal ultrasonography. Cholecystectomy is recommended for all patients with a polyp larger than 1 cm.

摘要

无症状胆结石患者通常无需治疗。大多数有症状的胆结石患者需要手术干预。对于无并发症的胆囊炎患者,入院后24小时内进行腹腔镜胆囊切除术可显著降低发病率、缩短住院时间并降低费用。大多数胆囊息肉是在超声检查时偶然发现的。胆囊息肉患者如果年龄超过50岁、胆囊壁增厚、息肉为腺瘤性、单发、直径大于10毫米、外观呈无蒂状或大小迅速增加,则发生恶性转化的风险增加。使用经腹超声鉴别良性和恶性息肉至关重要,但有时也很困难。对于所有息肉大于1厘米的患者,建议行胆囊切除术。

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