2 419例17 530颗胆囊息肉内镜微创保胆手术后病理结果分析

Pathological analysis of minimally invasive surgery of gallbladder-preserving cholecystolithotomy operation on 17 530 gallbladder polyps in 2 419 cases

摘要:

目的 通过对胆囊息肉保胆手术后病理结果分析，评估内镜微创保胆手术对胆囊息肉的治疗价值。方法 收集2007年1月－2020年12月行内镜微创保胆手术的2 419例17 530颗胆囊息肉患者的病理资料，纳入回顾性研究，以内镜微创保胆手术的手术适应证作为入组标准，分析其术后病理结果。结果 胆囊良性息肉占99.68%，均行保胆取息肉手术，0.20%的患者息肉为恶性，且为早期，均行胆囊癌根治术，0.12%的患者为腺瘤高级别上皮内瘤变，行胆囊切除术。结论 胆囊息肉中恶性肿瘤占比较低，内镜微创保胆手术是治疗胆囊息肉的首选手术方法，既可以去除胆囊良性病变，又能保留胆囊功能，还可以早期发现胆囊癌。因此，胆囊息肉应早期行微创保胆手术以明确诊断，防止恶变。

Abstract:

Objective To evaluate the therapeutic value of endoscopic minimally invasive gallbladder conserving surgery for gallbladder polyps by analyzing the pathological results of gallbladder polyps after gallbladder conserving surgery.Methods The pathological data of 2 419 patients with 17 530 gallbladder polyps who underwent endoscopic minimally invasive gallbladder preservation surgery from January 2007 to December 2020 were collected and included in the regression study. The surgical indications of endoscopic minimally invasive gallbladder preservation surgery were used as the inclusion criteria, and the postoperative pathological results were analyzed.Results Benign polyps of gallbladder accounted for 99.68%, all patients underwent gallblader-preserving polyp surgery, only 0.20% of the patients had malignant and early polyps, all the patients underwent radical resection of gallbladder cancer, 0.12% of the patients suffered from high-grade intraepithelial neoplasia and had cholecystectomy.Conclusion Endoscopic minimally invasive gallbladder conserving surgery is the first choice for the treatment of gallbladder polyps, which can remove the benign lesions of the gallbladder, preserve the function of the gallbladder, and can also detect gallbladder cancer in the early stage. Therefore, minimally invasive gallblade-preserving surgery should be performed early for gallbladder polyps in order to make a clear diagnosis and prevent malignant transformation.