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胆囊息肉管理的新进展:预测模型的确立和保胆息肉切除术的兴起。

Advances in the management of gallbladder polyps: establishment of predictive models and the rise of gallbladder-preserving polypectomy procedures.

机构信息

Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Pinghai Road, Gusu District, Suzhou, 215000, Jiangsu, China.

出版信息

BMC Gastroenterol. 2024 Jan 2;24(1):7. doi: 10.1186/s12876-023-03094-7.

Abstract

Gallbladder polyps are a common biliary tract disease whose treatment options have yet to be fully established. The indication of "polyps ≥ 10 mm in diameter" for cholecystectomy increases the possibility of gallbladder excision due to benign polyps. Compared to enumeration of risk factors in clinical guidelines, predictive models based on statistical methods and artificial intelligence provide a more intuitive representation of the malignancy degree of gallbladder polyps. Minimally invasive gallbladder-preserving polypectomy procedures, as a combination of checking and therapeutic approaches that allow for eradication of lesions and preservation of a functional gallbladder at the same time, have been shown to maximize the benefits to patients with benign polyps. Despite the reported good outcomes of predictive models and gallbladder-preserving polypectomy procedures, the studies were associated with various limitations, including small sample sizes, insufficient data types, and unknown long-term efficacy, thereby enhancing the need for multicenter and large-scale clinical studies. In conclusion, the emergence of predictive models and minimally invasive gallbladder-preserving polypectomy procedures has signaled an ever increasing attention to the role of the gallbladder and clinical management of gallbladder polyps.

摘要

胆囊息肉是一种常见的胆道疾病,其治疗选择尚未完全确定。胆囊切除术的“息肉≥10 毫米直径”指征增加了因良性息肉而切除胆囊的可能性。与临床指南中列举的危险因素相比,基于统计方法和人工智能的预测模型更直观地表示了胆囊息肉的恶性程度。微创保胆息肉切除术作为一种检查和治疗方法的结合,可以同时消除病变并保留功能正常的胆囊,最大限度地为良性息肉患者带来益处。尽管预测模型和保胆息肉切除术的报告结果良好,但这些研究存在各种局限性,包括样本量小、数据类型不足和长期疗效未知,因此需要进行多中心和大规模的临床研究。总之,预测模型和微创保胆息肉切除术的出现表明,人们对胆囊的作用和胆囊息肉的临床管理越来越重视。

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