胆囊腺肌增生症23例临床分析

目的探讨胆囊腺肌增生症的病因、诊断和治疗方法。方法在1046例胆囊切除术中,对病理检查确诊的23例胆囊腺肌增生症的临床资料进行回顾性分析,患者术前均行超声、CT或MRI检查。结果23例胆囊腺肌增生症临床表现与慢性胆囊炎胆石症类似。病变大体形态:局限型13例(均位于胆囊底部)、节段型7例和弥漫型3例。23例均行胆囊切除,合并胆囊结石6例,合并胆囊炎14例。结论胆囊腺肌增生症是一种好发于成年人的胆囊壁增生性病变,此病常与慢性胆囊炎、胆石症并存,临床诊断困难,确诊需依赖病理检查。联合超声、CT和MRI等影像学检查可提高术前诊断准确度。目前手术是治疗的最好方法。

Clinical analysis of 23 cases of adenomyomatosis of gallbladder

Objective To study the etiology,diagnosis and therapy of adenomyomatosis of gallbladder(ADM),Methods Retrospective analysis was performed in 23 cases of ADM arisen from 1046 cholecystectomy specimens over 5 years in our hospital.All cases underwent pre-operation US,CT,or MRI.Results The clinical manifestation of the patients with ADM was similar to that of the chronic cholecystitis or cholelithiasis.Grossly,there were three growth patterns of the lesion,localized(13),segmental(7) and diffused types(3).Cholecystectomy was performed in all cases.Much of cases were accompanied with cholecystitis(14) and cholelithiasis(6).Conclusion ADM is a tumor-like lesion that occurs predominantly in adult.It frequently coexists with chronic cholecystitis and cholelithiasis.It is difficult to make the diagnosis for clinicians.Pathological confirmation of the diagnosis is always needed.The accuracy of preoperative diagnosis may be improved by combining diagnosis imaging of ADM,Cholecystectomy is the best method of the therapy on ADM.