Investigation Into The Diagnosis And Treatment Of The Apophysis Lesions Of Gallbladder

Background and Objective With the wide utilization of B-ultrasonography in recent yeas,the detection rate of the apophysis lesions of gallbladder has reached to 1%in natural crowd and ALG has become a common disease in surgery.It is difficult to identify the nature of ALG before preoperatively hence it is a problem to determine how to treat ALG and when to take operation.This study aimed to find the significant index for prognosis and treatment and investigate the possible canceration factors and diagnosis and treatment principles of ALG by analyzing clinic feature of it.Materials and Methods Clinical and pathological features of 553 cases were analyzed retrospectively.All cases which come from Qingdao municipal hospital and Yantai Yuhuangding hospital were given operation and made a definite diagnosis pathologically postoperatively.The data recorded included the common information, clinical situation,B-ultrasonography,pathological analysis and diagnosis.Group the cases according to pathological diagnosis and compare the data of each group.Statistical analysis was made through spss13.0.Results Totally 501 patients received B-ultrasonography.37.3%of all patients was mail and the rest was female.88.1 percent of all patients had symptoms and the course of diseases ranged from 1 day to 30 years.Pathologically,515 patients with benign apophysis lesions(including 361 cholesterol polyps and 40 adenoma) were included:the diameter of 84.7 percent of cholesterol polyps were less then 10 mm,and more then half of them were multiple;most adenoma were single polyp and the average diameter of them was 6.0±3.4 mm;age of onset in benign ALG was under 60-years old.88 percent of patients with benign lesions had symptoms(167/190).38 patients with malignant apophysis lesions(including 37 adenocarcinoma) were included:the average diameter of gallbladder carcinoma was 11.2±3.1 mm;most malignant polyps were single polyp;in 38 patients with gallbladder carcinoma,32 were accompanied with gallbladder stone(84.2%); all patients with malignant polyps were over 45 years.In addition,the final diagnosis rate of B-ultrosonography was 43.3%.Conclusions Cholesterol polyp and adenoma are the most conmen lesions in benign plypoid lesion of gallbladder;and adenocarcinoma is the most common malignant lesions. Cholecystectomy should be done in patients with symptoms.The risk factors for malignancy are the age of the patient(＞60),the size(＞10mm),and combined with stone. In asymptomatic patients,cholecystectomy can be justified after integrated analysis.