BibTex RIS Kaynak Göster

Our surgical experience in gall bladder polyps

Yıl 2013, Cilt: 19 Sayı: 3, 169 - 172, 01.04.2013
https://doi.org/10.5455/GMJ-30-2013-159

Öz

Our study includes the retrospective analysis of 35 patients who were operated with the diagnosis of gallbladder polyp, between May 2005 and June 2011 at Ankara Numune Training and Research Hospital, 3rd Department of General Surgery. In this period 59 patients were diagnosed by gallbladder polyps, but only 35 of them were operated. Twenty one of 35 patients who were operated in our clinic with the diagnosis of gallbladder polyps, were female (%60) and 14 were male (40%). The mean age was 47.1. In all cases, ultrasound is used as a radiological examination. According to the preoperative ultrasonography reports of the patients; in 14 (40%) cases there was a single polyp, in 7 (20%) cases there were multiple polyps, in 13 (37.2%) cases there were polyps and gallstones and in 1 (2.8%) case his findings were suspicious for malignancy. We performed laparoscopic cholecystectomy to 32 (91.5%) of 35 patients and 3 patients (8.5%) were performed open cholecystectomy. According to histopathological examination, cholesterol polyps in 19 patients, cholesterol polyps + cholelithiasis in 13 patients, adenomatous polyp in one patient, and adenocarcinoma of the gallbladder in one patient were found. During the pathological examination of a patient who was operated with the diagnosis of polyp; there was no polyp detected, and a gallstone adherent to the gallbladder wall was observed. As a result, even if there is no symptom, surgical treatment must be performed to the patients over 50 years of age, with a polyp size over 10 mm, and with cholelithiasis, because of the possibility of malignancy. The cases with polyp size under 10 mm must be followed up with a 6 months period by ultrasonographic examination. During this time; surgery must be considered if there is an increase in polyp size and number of polyps or symptoms were developed.

Kaynakça

  • 1. Persley KM. Gallbladder polyps. Curr Treat Options Gastroenterol 2005;8(2):105-8.
  • 2. Yang HL, Sun YG, Wang Z. Polypoid lesions of the gallbladder: diagnosis and indications for surgery. Br J Surg 1992;79(3):227-9.
  • 3. Jones-Monahan KS, Gruenberg JC, Finger JE, Tong GK. Isolated small gallbladder polyps: an indication for cholecystectomy in symptomatic patients. Am Surg 2000; 66(8):716-9. 4. Terzi C, Sökmen S, Seçkin S, Albayrak L, Uğurlu M. Polypoid lesions of the gallbladder: report of 100 cases with special reference to operative indications. Surgery 2000;127(6):622-7.
  • 5. Azuma T, Yoshikawa T, Araida T, Takasaki K. Differential diagnosis of polypoid lesions of gallbladder by endoscopic ultrasonography. Am J Surg 2001;181(1):65-70.
  • 6. Csendes A, Burgos AM, Csendes P, Smok G, Rojas J. Late follow-up of polypoid lesions of the gallbadder smaller than 10 mm. Ann Surg 2001;234(5):657-60.
  • 7. Sadamoto Y, Oda S, Tanaka M, Harada N, Kubo H, Eguchi T, et al. A useful approach to the differential diagnosis of small polypoid lesions of the gallbladder, utilizing an endoscopic ultrasound scoring system. Endoscopy 2002;34(12):959-65.
  • 8. Sugiyama M, Atomi Y, Yamato T. Endoscopic ultrasonography for differential diagnosis of polypoid gall bladder lesions: analysis in surgical and follow up series. Gut 2000;46(2):250-4.
  • 9. Bartlett DL. Gallbladder Cancer. Semin Surg Oncol 2000;19(2):145-55.
  • 10. Chen CY, Lu CL, Chang FY, Lee SD. Risk factors for gallbladder polyps in the Chinese population. Am J Gastroenterol 1997;92(11):2066-8.
  • 11. Lee KF, Wong J, Li JC, Lai PB. Polypoid lesions of the gallbladder. Am J Surg 2004;188(2):186-90.
  • 12. Myers RP, Shaffer EA, Beck PL. Gallbladder polyps: epidemiology, natural history and management. Can J Gastroenterol 2002;16(3):187-94.
  • 13. Ozdemir A, Ozenc A, Bozoklu S, Coskun T. Ultrosonography in the diagnosis of gallbladder polyps. Br J Surg 1993;80(3):345.
  • 14. He ZM, Hu XQ, Zhou ZX. Consideration on indications for surgery in patients with polypoid lesion of the gallbladder. Di Yi Jun Yi Da Xue Xue Bao 2002;22(10):951-2.
  • 15. Erden A, Songür Y, Şahin T, Alimoğlu E, Cumhur T, Temuçin G. The role of color Doppler ultrasonography in the differentiation of gallbladder lesions. Turk J Gastroenterol 1999;10(2):132-7.
  • 16. Sun XJ, Shi JS, Han Y. Diagnosis and treatment of polypoid lesions of the gallbladder: report of 194 cases. Hepatobiliary Pancreat Dis Int 2004;3(4):591-4.
  • 17. Lou MW, Hu WD, Fan Y, Chen JH, E ZS, Yang GF. CT biliary cystoscopy of gallbladder polyps. World J Gastroenterol 2004;10(8):1204-7.
  • 18. Shinkai H, Kimura W, MutoT. Surgical indications for small polypoid lesions of the gallbladder. Am J Surg 1998;175(2):114-7.

Safra kesesi poliplerinde cerrahi deneyimimiz

Yıl 2013, Cilt: 19 Sayı: 3, 169 - 172, 01.04.2013
https://doi.org/10.5455/GMJ-30-2013-159

Öz

Çalışma; Ankara Numune Eğitim ve Araştırma Hastanesi 3. Genel Cerrahi Kliniğine, Mayıs 2005 ile Haziran 2011 tarihleri arasında safra kesesi polibi tanısı almış, verilerine ulaşılan 59 hastadan opere edilen 35 hastanın retrospektif analizini içermektedir. Klinikte safra kesesi polibi tanısı ile opere edilen 35 hastanın 21'i (%60) kadın; 14'ü (%40) erkekti. Ortalama yaş 47.1 idi. Tüm olgularda radyolojik tetkik olarak ultrasonografi kullanıldı. Hastaların preoperatif dönemde yapılan ultrasonografilerinde; 14 (%40) olguda tek polip; 7 (%20) olguda multipl polip; 13 (%37.2) olguda polip ve safra kesesi taşı; 1 (%2.8) olguda malignite açısından şüpheli bulgulara rastlandı. Otuz beş hastadan; 32'sine (%91.5) laparoskopik kolesistektomi, 3'üne (%8.5) ise açık kolesistektomi uygulanmıştır. Hitopatolojik incelemede; 19 hastada kollesterol polibi; 13 hastada kolesterol polibi + kolelitiazis, 1 hastada adenomatöz polip, 1 hastada safra kesesi adenokanseri saptanmıştır. Polip tanısı ile opere edilen 1 hastanın patolojik incelemesinde polip saptanmamış ve safra kesesi duvarına yapışık 1 adet safra taşı izlenmiştir. Sonuç olarak, semptomatik olmasa bile 50 yaş üzerinde, polip boyutu 10 mm üzerinde olan, kolelitiazis ile birlikte olan olgularda malignite ihtimali olduğundan dolayı cerrahi tedavi uygulanmalıdır. Bunların dışında 10 mm'nin altında olan olgular 6 aylık periyotlarla ultrasonografi izlem programına alınmalıdırlar. Bu zaman zarfında polip boyutlarında büyüme, polip sayılarında artış olursa, semptomlar gelişirse cerrahi tedavi gündeme getirilmelidir.

Kaynakça

  • 1. Persley KM. Gallbladder polyps. Curr Treat Options Gastroenterol 2005;8(2):105-8.
  • 2. Yang HL, Sun YG, Wang Z. Polypoid lesions of the gallbladder: diagnosis and indications for surgery. Br J Surg 1992;79(3):227-9.
  • 3. Jones-Monahan KS, Gruenberg JC, Finger JE, Tong GK. Isolated small gallbladder polyps: an indication for cholecystectomy in symptomatic patients. Am Surg 2000; 66(8):716-9. 4. Terzi C, Sökmen S, Seçkin S, Albayrak L, Uğurlu M. Polypoid lesions of the gallbladder: report of 100 cases with special reference to operative indications. Surgery 2000;127(6):622-7.
  • 5. Azuma T, Yoshikawa T, Araida T, Takasaki K. Differential diagnosis of polypoid lesions of gallbladder by endoscopic ultrasonography. Am J Surg 2001;181(1):65-70.
  • 6. Csendes A, Burgos AM, Csendes P, Smok G, Rojas J. Late follow-up of polypoid lesions of the gallbadder smaller than 10 mm. Ann Surg 2001;234(5):657-60.
  • 7. Sadamoto Y, Oda S, Tanaka M, Harada N, Kubo H, Eguchi T, et al. A useful approach to the differential diagnosis of small polypoid lesions of the gallbladder, utilizing an endoscopic ultrasound scoring system. Endoscopy 2002;34(12):959-65.
  • 8. Sugiyama M, Atomi Y, Yamato T. Endoscopic ultrasonography for differential diagnosis of polypoid gall bladder lesions: analysis in surgical and follow up series. Gut 2000;46(2):250-4.
  • 9. Bartlett DL. Gallbladder Cancer. Semin Surg Oncol 2000;19(2):145-55.
  • 10. Chen CY, Lu CL, Chang FY, Lee SD. Risk factors for gallbladder polyps in the Chinese population. Am J Gastroenterol 1997;92(11):2066-8.
  • 11. Lee KF, Wong J, Li JC, Lai PB. Polypoid lesions of the gallbladder. Am J Surg 2004;188(2):186-90.
  • 12. Myers RP, Shaffer EA, Beck PL. Gallbladder polyps: epidemiology, natural history and management. Can J Gastroenterol 2002;16(3):187-94.
  • 13. Ozdemir A, Ozenc A, Bozoklu S, Coskun T. Ultrosonography in the diagnosis of gallbladder polyps. Br J Surg 1993;80(3):345.
  • 14. He ZM, Hu XQ, Zhou ZX. Consideration on indications for surgery in patients with polypoid lesion of the gallbladder. Di Yi Jun Yi Da Xue Xue Bao 2002;22(10):951-2.
  • 15. Erden A, Songür Y, Şahin T, Alimoğlu E, Cumhur T, Temuçin G. The role of color Doppler ultrasonography in the differentiation of gallbladder lesions. Turk J Gastroenterol 1999;10(2):132-7.
  • 16. Sun XJ, Shi JS, Han Y. Diagnosis and treatment of polypoid lesions of the gallbladder: report of 194 cases. Hepatobiliary Pancreat Dis Int 2004;3(4):591-4.
  • 17. Lou MW, Hu WD, Fan Y, Chen JH, E ZS, Yang GF. CT biliary cystoscopy of gallbladder polyps. World J Gastroenterol 2004;10(8):1204-7.
  • 18. Shinkai H, Kimura W, MutoT. Surgical indications for small polypoid lesions of the gallbladder. Am J Surg 1998;175(2):114-7.
Toplam 17 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Makaleler
Yazarlar

Tolga Dinç Bu kişi benim

Faruk Coşkun Bu kişi benim

Kutlu Özlem Küçük Bu kişi benim

Yayımlanma Tarihi 1 Nisan 2013
Yayımlandığı Sayı Yıl 2013 Cilt: 19 Sayı: 3

Kaynak Göster

APA Dinç, T., Coşkun, F., & Küçük, K. Ö. (2013). Safra kesesi poliplerinde cerrahi deneyimimiz. Gaziantep Medical Journal, 19(3), 169-172. https://doi.org/10.5455/GMJ-30-2013-159
AMA Dinç T, Coşkun F, Küçük KÖ. Safra kesesi poliplerinde cerrahi deneyimimiz. Gaziantep Medical Journal. Nisan 2013;19(3):169-172. doi:10.5455/GMJ-30-2013-159
Chicago Dinç, Tolga, Faruk Coşkun, ve Kutlu Özlem Küçük. “Safra Kesesi Poliplerinde Cerrahi Deneyimimiz”. Gaziantep Medical Journal 19, sy. 3 (Nisan 2013): 169-72. https://doi.org/10.5455/GMJ-30-2013-159.
EndNote Dinç T, Coşkun F, Küçük KÖ (01 Nisan 2013) Safra kesesi poliplerinde cerrahi deneyimimiz. Gaziantep Medical Journal 19 3 169–172.
IEEE T. Dinç, F. Coşkun, ve K. Ö. Küçük, “Safra kesesi poliplerinde cerrahi deneyimimiz”, Gaziantep Medical Journal, c. 19, sy. 3, ss. 169–172, 2013, doi: 10.5455/GMJ-30-2013-159.
ISNAD Dinç, Tolga vd. “Safra Kesesi Poliplerinde Cerrahi Deneyimimiz”. Gaziantep Medical Journal 19/3 (Nisan 2013), 169-172. https://doi.org/10.5455/GMJ-30-2013-159.
JAMA Dinç T, Coşkun F, Küçük KÖ. Safra kesesi poliplerinde cerrahi deneyimimiz. Gaziantep Medical Journal. 2013;19:169–172.
MLA Dinç, Tolga vd. “Safra Kesesi Poliplerinde Cerrahi Deneyimimiz”. Gaziantep Medical Journal, c. 19, sy. 3, 2013, ss. 169-72, doi:10.5455/GMJ-30-2013-159.
Vancouver Dinç T, Coşkun F, Küçük KÖ. Safra kesesi poliplerinde cerrahi deneyimimiz. Gaziantep Medical Journal. 2013;19(3):169-72.