Evaluation Of Surgical Treatment For Different Types Of Gallbladder Adenomyomatosis

Objective:To compare the difference of clinical biochemical statistics in different types of gallbladder adenomyomatosis.To investigate the different effect of patients between the three different types of gallbladder adenomyomatosis.Methods:Retrospective analysis the clinical data of the adenomyomatosis patients that come from our hospital between the 2010 to 2018.According to the preoperative image,it could be divided to three groups:(Group A)fundal(localized)type;(Group B)segmental type;(Group C)diffuse type.The number of each group is:136,27,17.We analyse the biochemical statistics(total bilirubin,direct bilirubin,serum bile acid,ALT,AST,cholinesterase,etc.)of the three groups to explore the difference on operative mode,operative time and prognosis between these three group.Results:(1)In the liver function statistics,AST has the statistical significance(F=4.974,P=0.012);(2)And the diffuse adenomyomatosis might have a higher bile acid(F=6.048,P=0.005);(3)The segmental and diffuse adenomyomatosis is easier to be combined with stones(F=19.226,P<0.001);(4)The fundal adenomyomatosis seems to have a better prognosis:fewer hospital stay(F=4.519,P=0.018),fewer drainage time(F=6.575,P=0.004)and fewer complications(X2=29.429,P<0.001).Conclusion:Gallbladder adenomyomatosis(GA)is a disease characterized by epithelial proliferation and hypertrophy of the muscles of the gallbladder wall with an outpouching of the mucosa into or through the thickened muscular layer and cannot be regarded as a precancerous lesion based on available evidence.n.As for asymptomatic GA,a conservative treatment is recommended with US exams twice a year.The fundal type GA can be treated by partial laparoscopic cholecystectomy.The segmental and diffuse type should undergo a total laparoscopic cholecystectomy.