Clinical Analysis Of 125 Cases With Polypoid Lesions Of The Gallbladder

Objective:To analyze the characteristics of the cases of the polypoid lesions of the gallbladder ,sum up the experience of diagnosis and treatment about PLG.Methods:Retrospective analysis of 116 case of PLG for cholecystectomy between January 2002 and September 2008 about their clinical and pathological features.SPSS17.0 statistical software package is used in date collation and description analysis as a statistical.Results:In 82 cases of non-neoplastic polyps, 56 cases of cholesterol polyp (44.8%), 16 cases of adenomyosis (12.8%), 10 cases of hyperplastic polyps (8%). In 43 cases of neoplastic polyps, 25 cases of adenoma (20%), 18 cases of gallbladder carcinoma (14.4%), 9 cases of cancer for the adenoma. In non-neoplastic polyps, there are 64.63% (53 cases) in diameter <10mm; 43 patients with tumors of PLG of which 86% (37 cases) is more than 10mm in diameter. Diameter <15mm has 86 cases (68.8%) are benign polyps. Between the 15-20mm is 13 cases, one of 3 cases (23%) for gallbladder cancer, and carcinogenesis from adenoma. PLG more than 20mm in diameter is 25 cases, of which 15 cases (60%) are gallbladder cancer. Non-neoplastic PLG has 29.27% (24 cases) as for a single,and PLG of the tumor has 83.7% (36 cases) as a single. 88.9% of gallbladder cancer group (16 cases) is the single polyps. The diameter of polyps (≥10mm) and the single are the two risk factors of neoplastic and non-neoplastic polyps. Diameter of benign and malignant polyps is a risk factor.Conclusion: 1.The difference of neoplastic and non-neoplastic is diameter and single.2.Surgical indications for PLG is:(1) Diameter≥10mm; (2)Single,broad-based,thick pedicle.(3)Age greater than 50-year-old.(4)Gallstone or combined with clinical symptoms.(5)Lesions increased rapidly;(6)Location in the gallbladder neck.(7)Diameter <10mm of PLG, without the above situation, should be followed up, not surgery.3. Non-neoplastic polyps or neoplastic polyps less than 2cm in diameter should be selected LC. Laparotomy should be selected for the neoplastic polyps greater than 2cm in diameter or highly suspected cancer;The simple cholecystectomy (LC or OC) is suitable for the phase Tis,T1 of gallbladder cancer and phase T2 be held in gallbladder radical mastectomy.5. All the PLG of diameter <15mm are benign polyps.The PLG of diameter between 15-20mm is 23% for the gallbladder cancer. the PLG of diameter > 20mm is 60% for gallbladder cancer...