【摘要】 目的 探讨胆囊腺肌增生症的临床特点及治疗方法。__ 方法 回顾性分析1992年至2007年收治的33例胆囊腺肌增生症临床资料。___ 结果 本组33例患者中弥漫型14例(42.4%)，___节段型10例(30.3%)，_局限型9例(27.3%)。合并胆囊结石21例(63.6%)，_合并胆囊炎11例(33.3%)。_临床症状无特征性表现，_以上腹疼痛、进食后不适、恶心呕吐为主。术前临床疑诊4例，__影像学正确诊断2例。_28例行腹腔镜胆囊切除术，___3例行开腹胆囊切除术，___1例同时行胆总管探查、T管引流术，__1例同时行肝血管瘤切除术。_术后病理诊断均为胆囊腺肌增生症。_ 结论 胆囊腺肌增生症常合并胆囊结石、胆囊炎，_临床表现不具特异性，__术前确诊依赖于影像学检查。_该病有潜在恶性变可能，_胆囊切除术为有效的治疗方法。__四川大学华西医院胃肠外科杜潇
【关键词】 胆囊疾病；胆囊腺肌增生症；诊断；治疗
【Abstact】 ObjectiveTo investigate theclinical feature and treatment of adenomyomatosis of the gallbladder (GBA). MethodsThirty-three cases of GBA admitted from 1992 to 2007 were reviewedretrospectively and their clinical characters have been summarized. Results All the cases are divided into threetypes grossly:14 for diffuse type,10 for segmental type and 9 cases forlocalized type. 21 cases associated with cholelithiasis and 11 cases with cholecystitis. The major clinical presentations includedpainfulness in the upper abdomen, discomfort after ingesting, nausea and vomit whichhave no specificity. Only six cases of this group were diagnosed correctlybefore operation. Twenty-eight laparoscopic cholecystectomy and three opencholecystectomy were performed. 2 patients respectively accepted exploration ofcommon bile duct with T tube drainage and resection of liver angioma simultaneously.All cases have been proven to be adenomyomatosis of the gallbladder by pathologicexamination. Conclusions Due to the highrate of combination with cholelithiasis and cholecystitis, GBA has no specificclinical manifestations. The preoperative diagnosis lies on radiologicalexaminations. Cholecystectomy is an appropriate method in treatment as the adenomyomatosis of the gallbladder has a malignant potential.
【Key words】 Gallbladder disease; Adenomyomatosis of the gallbladder; Diagnosis;Treatment