摘要
胆囊息肉是胆道外科常见多发病，临床表现缺乏特异性，近些年随着健康体检的广泛开展，彩色多普勒超声检查技术不断提高，其检出率越来越高。虽然胆囊息肉恶变率不高，一旦恶变，其恶性程度较高，预后极差，而早期发现预后相对较好。目前胆囊切除术是治疗胆囊息肉的主流方法，但不充分考虑胆囊缺失所带来的系列问题而笼统行胆囊切除术，已不能满足患者对术后生活质量的更高要求，亦不符合当前精准医学的方向。随着腔镜技术迅猛发展，近些年，腔镜辅助小切口胆囊息肉切除术、全腔镜下胆囊息肉切除术、腹腔镜下胆囊黏膜反转法息肉切除术等微创保胆手术再次得到一些学者及医疗研究机构的推崇，其结果优势明显。然而，什么样的胆囊息肉才需要治疗、选择何种术式治疗、手术时机如何把握尚存争议，未形成统一标准，也缺乏多中心、大宗的前瞻性研究和远期追踪探索与研究；随着进一步深入研究，寻找充足的循证医学依据，必须建立共识与指南规范，使诊治规范化、患者获益最大化。
The gallbladder polyps is a common and frequently - occurring disease , and lacks of specificity in clinical manifestations. In recent years, with the improvement of healthy check-up and development of colour Doppler ultrasound technology, the detection rate of gallbladder polyps is higher and higher. Although malignant rate of gallbladder polyps is not high, the malignancy degree will be high and prognosis will be poor once it is malignant. Contrarily, early detection has good prognosis relatively. The cholecystectomy is one of the main methods for treatment of gallbladder polyps. But performing cholecystectomy with taking no account of the series of problems caused by gallbladder missing can not meet the requirement of quality of postoperative life and cannot be compliant to the orientation of precision medicine. With the rapid development of cavity mirror technology, in recent years, minimally invasive treatments with reserving gallbladder, such as endoscopy assisted gallbladder polyps resection with small incision, gallbladder polyps resection under cavity mirrors and laparoscopic gallbladder polyps resection with mucosa inversion method, which have obvious advantages in outcomes, are studied and recommended by some scholars. However, there is no unified standard for the controversial problems such as what kind of gallbladder polyps should be treated, how to choose the surgery method, and how to consider the timing of treatment. And we lack of multi-center large prospective, long-term follow-up investigation and research. With further research and sufficient evidence, the consensus and guidelines should be established to standardize diagnosis and treatment, and maximize the benefit of patients.
作者
李连发
李桂萍
游春艳
周永宏
柏纯
Li Lianfa, Li Guiping, You Chunyan, Zhou Yonghong, Bai Chun(Department of Cardiac Surgery, the Sixth Affiliated Hospital of Kunming Medical University, Yunxi 653100, Chin)
出处
《中国实用医刊》
2018年第1期117-121,共5页
Chinese Journal of Practical Medicine
关键词
胆囊息肉
微创保胆
随机对照
Gallbladder polyps
Minimally invasive treatment with gallbladder reserved
Randomized control
