Clinical Analysis And Operative Time Of Polypoid Lesion Of The Gallbladder

Objectives Through a retrospective study of the data of 171 patients who underwent laparoscopic cholecystectomy(LC)or open cholecystectomy(OC)in the Hepatobiliary,Pancreaticobiliary and Splenic surgery area of Hebei General Hospital,Analysis Polypoid Lesion of Gallbladder(PLG)in different age,gender,number of lesions,lesion diameter,clinical symptoms,B-ultrasound echo strength,combined with gallbladder stones or(and)cholecystitis and other factors,the differences between benign and malignant,neoplastic and non-neoplastic PLG,to clarify the pathogenic risk factors of PLG,and to find out the optimal surgical resection time.Methods Collecting of the cases of PLG hospitalized and treated by LC or OC in the Hepatobiliary,Pancreaticobiliary and Splenic surgery area of Hebei General Hospital from October 2018 to October 2020,and the diagnosis of gallbladder invasive carcinoma before surgery or postoperative pathological report without PLG were excluded.For the continuous variables of age and polyp diameter of the two PLG malignant risk factors,the ROC curve was used to obtain the threshold according to the Youden index,and the best cut-off point was selected according to the clinical reality,and all cases were grouped by age and polyp diameter,according to the pathological type and the benign and malignant nature of the lesion,PLG was divided into benign and malignant polyp group,non-tumor group and tumor group,gallbladder adenoma and non-neoplastic polyp group,gallbladder adenoma and gallbladder carcinoma group,and determined by multivariate logistic regression analysis.For the risk factors of benign and malignant,neoplastic and nonneoplastic PLG,the Chi-square test was used to compare the differences between the groups under single factor.Results A total of 171 patients were included,including 156 cases of benign PLG(91.2%),15 cases of malignant PLG(8.8%),125 cases of non-neoplastic PLG(73.1%),and 46 cases of neoplastic PLG(26.9%).Draw the ROC curve of two continuous variables of age and polyp diameter,and obtain the age threshold of 54.5 years and the diameter threshold of 10.8mm.According to clinical practice,the best age cut-off point is 55 years old,and the optimal cut-off point for polyp diameter was 10 mm.The risk factors for malignant transformation of PLG were analyzed by multivariate Logistics regression,including age and polyp diameter.The P values of both were less than 0.05,and the difference was statistically significant.The difference was statistically significant(P < 0.05)in the number of polyps,diameter of lesions,abdominal symptoms and B-ultrasound echo strength between the two groups;the difference was statistically significant(P < 0.05)in the age,number of polyps,diameter of lesions,abdominal symptoms and B-ultrasound echo strength between benign and malignant PLG There was statistical significance;the P values of age,polyp number,lesion diameter,abdominal symptoms,gallstone with or without cholecystitis,and B-ultrasound echo intensity in gallbladder adenoma and non neoplastic PLG were all < 0.05,with statistical significance;the P values of age,lesion diameter,abdominal symptoms in gallbladder adenoma and gallbladder cancer were all <0.05,with statistical significance The P values of the risk factors of cholecystitis,cholecystolithiasis with or without cholecystitis and the intensity of B-ultrasound echo were all < 0.05,and the differences were statistically significant.Conclusions 1 Age ≥ 55 years and polyp diameter ≥ 10 mm were independent risk factors for PLG malignant transformation.2 The risk factors for distinguishing between neoplastic and non-neoplastic PLG were the number of polyps,the diameter of the polyps,the presence or absence of abdominal symptoms,and the intensity of B-ultrasound echo.3The indications for PLG operation are: age ≥ 60 years old,polyp diameter ≥ 10 mm,single polyp,sessile or wide base,lesions under B-ultrasound or low heterogeneous echo,persistent abdominal symptoms,combined with gallbladder stones with or without cholecystitis.Figure 2;Table 7;Reference 159...