Karim M M, Ahmed E U, Mozumder S, Zebunnesa M, Azad K A
Dr Mohammad Masud Karim, Associate Professor, Department of Surgery, Chittagong Medical College & Hospital (CMCH), Chattogram, Bangladesh; E-mail:
Mymensingh Med J. 2021 Oct;30(4):1086-1092.
There are different types of gallbladder polyps having variable morphology and nature. Symptoms are vague and mostly diagnosed incidentally on abdominal ultrasound. Risk factors are many. Indications of surgery are not clearly understood due to lack of clinical evidence. This study was carried out to analyze the management of gallbladder polyp in our settings and review of available evidence. Patients who underwent clip less mini laparoscopic cholecystectomy for gallbladder polyp were included. Clinical data including short history, age, gender, parity, lab tests, ultrasound report and macroscopy were recorded during surgery. Histopathology reports collected later. Total of 112 patients with mean age 42.6 years (range 22-82), 74 of whom were female. Most of them (46.42%) were asymptomatic. Single polyp was in 69, multiple in 32 and polyp with stone in 8 patients. Sessile polyp was 74.10%. Average polyp size was 7.6mm. Cholesterol polyp was in 82 patients. Four out of 5 malignant polyps were single and sessile. Abdominal ultrasound is the mainstay of diagnosis of gallbladder polyp but size, location, morphology, number and presence of associated gallstone has to be mentioned. Symptomatic gallbladder polyp benefited from surgery. Polyps more than 6mm, single and sessile morphology above the age 50 should undergo cholecystectomy.
胆囊息肉有不同类型，形态和性质各异。症状不明确，大多在腹部超声检查时偶然发现。危险因素众多。由于缺乏临床证据，手术指征尚不明确。本研究旨在分析我院胆囊息肉的治疗情况并回顾现有证据。纳入因胆囊息肉接受无夹微创腹腔镜胆囊切除术的患者。手术期间记录临床资料，包括简要病史、年龄、性别、孕产史、实验室检查、超声报告和大体检查情况。随后收集组织病理学报告。共有112例患者，平均年龄42.6岁（范围22 - 82岁），其中74例为女性。大多数患者（46.42%）无症状。单发息肉69例，多发息肉32例，息肉合并结石8例。广基息肉占74.10%。息肉平均大小为7.6mm。胆固醇息肉82例。5例恶性息肉中有4例为单发广基息肉。腹部超声是胆囊息肉诊断的主要手段，但必须提及息肉的大小、位置、形态、数量及是否合并胆囊结石。有症状的胆囊息肉手术治疗有益。息肉大于6mm、单发、广基形态且年龄大于50岁者应行胆囊切除术。
