关键词: 无症状性胆囊结石, 胆囊息肉, 腹腔镜胆囊切除术, 过度治疗

Abstract:

Standardized treatment of asymptomatic gallstones and gallbladder polyps from the perspective of overtreatment and inadequate treatment        ZHAO Hai-ying，LIU Jin-gang. Department of General Surgery, the Fourth Affiliated Hospital of China Medical University，Shenyang 110032，China
Corresponding author：LIU Jin-gang，E-mail：liujg51347@
hotmail.com
Abstract    Domestic and international treatment guidelines recommend that asymptomatic gallstones do not need prophylactic laparoscopic cholecystectomy (LC), gallbladder polyps ≥1cm in diameter need LC. In clinical work, there may be overtreatment and inadequate treatment. It recommend that the majority of asymptomatic gallstones do not need prophylactic LC. For the patients in whom expecting treatment may increase the operation risk, observation should be preferred. In the presence of risk factors of gallbladder cancer, LC should be performed timely. In the presence of gallbladder wall thickening (＞3mm), regardless of the polyps size, LC should be recommended. Without gallbladder wall thickening, polyp ≥1cm, or increases rapidly in short term (＞3mm/6m), LC should be recommended. When the number of polyps increased or atypical abdominal symptoms is not in the indications for LC, observation should be preferred. Surgeons should pay attention to standardized treatment of asymptomatic gallstones and gallbladder polyps, strictly follow the guidelines, and avoid overtreatment, protect gallbladder function, and avoid inadequate treatment, perform LC for the precancerous lesions timely.

Key words: asymptomatic gallstones, gallbladder polyps, laparoscopic cholecystectomy, overtreatment