摘要
为了预防胆囊息肉的癌变或者避免漏诊胆囊癌，目前主流的做法是对大于1cm的息肉行胆囊切除术，而保胆手术则是把息肉大于0．5cm作为手术指征。导致这一结果的原因在于我们把直径大于1cm的胆囊息肉作为预测胆囊癌的高危因素，而忽视了大部分胆囊息肉即使是大于1cm也不是胆囊癌或者不会癌变的特点。本文从各种临床数据着手，分析胆囊癌真正的高危因素，指出预测胆囊癌的最有价值的指标是胆囊息肉的生长时间，患者的年龄，合并胆囊结石，息肉是否单发，以及患者的性别这5个因素。胆囊息肉直径大于1cm不是胆囊癌的危险因素。临床上可以综合利用这5个高危因素来合理管理胆囊息肉，减少不必要的胆囊切除手术和保胆取息肉手术。
In order to prevent the canceration of gall- bladder polyps or avoid the misdiagnosis of gallbladder cancer, the mainstream practice is cholecysteetomy for polyps larger than 1 cm, while gallbladder polyps larger than 0.5 cm as an indica- tion of gallbladder preserving surgery. The reasons for this result is that we put the diameter of more than 1 cm of gallbladder polyps as high risk factors for prediction of gallbladder carcino- ma, and we ignored the characteristics of gallbladder polyps that most of them are not gallbladder cancer or are not cancerous even larger than 1 cm. We analysed the high risk factors for gallbladder cancer on the basis of variety of clinical data, and we believe that the most valuable indicator of gallbladder cancer are the growth time of gallbladder polyps, the age of the patients, the combination of gallstones, the single polyps, and the sex. Polyps diameter greater than 1 cm are not a high risk factor for gallbladder cancer. We can use these five high risk factors to manage gallbladder polyps and reduce unnecessary cholecystec- tomy and gallbladder preserving surgery.
出处
《中华肝胆外科杂志》
CSCD
北大核心
2017年第12期861-864,共4页
Chinese Journal of Hepatobiliary Surgery
关键词
胆囊息肉
胆囊癌
高危因素
胆囊切除术
过度医疗
Gallbladder polyps
Gallbladder cancer
High risk factors
Cholecystectomy
Over-treatment
