对于胆囊聚的治疗和随访的修订指南没有减少不必要的胆囊切除术:POLYP研究的结果
Mike van Dooren1, Elise A J de Savornin Lohman1, Jarmila van der Bilt2
1Department of Surgery, Radboud University Medical Center, Nijmegen, the Netherlands.
United European gastroenterology journal
|July 23, 2025
概括
胆囊多指导方针表明,许多人需要手术,但大多数多都是非新形成的. 需要更好的风险评估来管理胆囊多,以避免不必要的手术.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 临床实践指南 临床实践指南
背景情况:
- 胆囊多影响高达7%的成年人,恶性瘤的风险较低.
- 由于恶性瘤发病率的区域差异,对于胆囊多的手术指南缺乏共识.
- 这项研究评估了关于胆囊多管理和手术指示的欧洲指南.
研究的目的:
- 为了比较欧洲胆囊多的实践指南.
- 评估指示胆囊切除术与实际术后发现的比率.
- 确定胆囊多管理算法需要改进的领域.
主要方法:
- 荷兰患者因胆囊聚体而接受随访或手术的回顾性分析 (2018-2020年).
- 包括26个中心的302名患者,评估人口统计,成像,手术和组织病理学.
- 胆囊切除术与2017年和2022年欧洲指导方针的比较.
主要成果:
- 88名患者 (29%) 接受了胆囊切除术; 81% (2017年指导方针) 和77% (2022年指导方针) 有迹象.
- 年龄标准指导方针的变化 (50至60岁) 影响了适应症.
- 在接受手术的患者中,69%患有非新发性息肉;只有9%患有腺瘤,其中3人患有低度生殖不良,3人患有高度生殖不良.
结论:
- 目前的指导方针导致许多非新发性胆囊多的随访和手术.
- 有相当数量的患者接受胆囊切除术,但没有发现瘤.
- 在胆囊聚体管理中需要增强风险分层算法.
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