PDF(Pubmed)
Abstract：
BACKGROUND: Gallbladder polyps are a general term for localized lesions in which the gallbladder wall protrudes into the gallbladder cavity, and benign lesions are common. Although current guidelines recommend cholecystectomy for gallbladder polyps ≥ 10 mm in size, the probability of finding cancer in postoperative pathological specimens is low. We should avoid unnecessary cholecystectomy and treat polyps with gallbladder preservation. Microwave ablation is safe and effective for the treatment of solid lesions, and can inactivates polyps while preserving gallbladder. Hence, we report a case of ultrasound-guided percutaneous microwave ablation of gallbladder polyps.
METHODS: A 72-year-old female patient had previously diagnosed a gallbladder polyp, but it was not taken seriously. Recently, the patient had occasional right upper abdominal discomfort and a desire to preserve gallbladder.
METHODS: Ultrasound showed a medium hyperechoic papillary protrusion in the gallbladder without echo behind, and the changed position did not move. Contrast-enhanced ultrasound (CEUS) showed no malignant signs. The diagnosis was a gallbladder polyp.
METHODS: The bile is drained and the drainage tube is fixed under real-time ultrasound guidance, then the gallbladder cavity is flushed and filled. Saline was injected between the serous and mucosal layers of the gallbladder to form an \"edema band\" to protect the gallbladder wall. Then, ultrasound-guided biopsy of gallbladder polyps was performed and sent for histological examination. Finally, the microwave needle was inserted into the target area under real-time ultrasonic guidance, and ablation was performed for 3 minutes (20 W). Postoperative CEUS: No significant enhancement was observed in the lesion.
RESULTS: Within 6 months of follow-up, the patient\'s gallbladder systolic function was normal, and there was no discomfort and no recurrence. The lesion reduction rate reached 100% at 1 week after surgery.
CONCLUSIONS: Ultrasound guided percutaneous microwave ablation of gallbladder polyps not only preserves the gallbladder but also inactivates the polyps without affecting the systolic function of the gallbladder, which provides a new idea for the treatment of gallbladder polyps.
METHODS: A 72-year-old female patient had previously diagnosed a gallbladder polyp, but it was not taken seriously. Recently, the patient had occasional right upper abdominal discomfort and a desire to preserve gallbladder.
METHODS: Ultrasound showed a medium hyperechoic papillary protrusion in the gallbladder without echo behind, and the changed position did not move. Contrast-enhanced ultrasound (CEUS) showed no malignant signs. The diagnosis was a gallbladder polyp.
METHODS: The bile is drained and the drainage tube is fixed under real-time ultrasound guidance, then the gallbladder cavity is flushed and filled. Saline was injected between the serous and mucosal layers of the gallbladder to form an \"edema band\" to protect the gallbladder wall. Then, ultrasound-guided biopsy of gallbladder polyps was performed and sent for histological examination. Finally, the microwave needle was inserted into the target area under real-time ultrasonic guidance, and ablation was performed for 3 minutes (20 W). Postoperative CEUS: No significant enhancement was observed in the lesion.
RESULTS: Within 6 months of follow-up, the patient\'s gallbladder systolic function was normal, and there was no discomfort and no recurrence. The lesion reduction rate reached 100% at 1 week after surgery.
CONCLUSIONS: Ultrasound guided percutaneous microwave ablation of gallbladder polyps not only preserves the gallbladder but also inactivates the polyps without affecting the systolic function of the gallbladder, which provides a new idea for the treatment of gallbladder polyps.
摘要：
背景：胆囊息肉是胆囊壁伸入胆囊腔的局部病变的总称，良性病变很常见。尽管目前的指南建议胆囊切除术治疗大小≥10mm的胆囊息肉，在术后病理标本中发现癌症的可能性较低。我们应避免不必要的胆囊切除术，并保留胆囊治疗息肉。微波消融治疗实性病变安全有效,并且可以在保留胆囊的同时灭活息肉。因此，我们报告1例超声引导下经皮微波消融术治疗胆囊息肉.
方法：一名72岁女性患者先前诊断为胆囊息肉，但没有认真对待。最近,患者偶尔有右上腹部不适和希望保留胆囊。
方法：超声显示胆囊有中度高回声乳头状突起，后面无回声，改变的位置没有移动。超声造影（CEUS）无恶性征象。诊断为胆囊息肉。
方法：在实时超声引导下引流胆汁并固定引流管，然后将胆囊腔冲洗并填充。在胆囊浆液层和粘膜层之间注射盐水，形成“水肿带”，以保护胆囊壁。然后，在超声引导下对胆囊息肉进行活检，并进行组织学检查。最后,在实时超声引导下将微波针插入目标区域，消融3分钟(20W)。术后超声造影：病灶未见明显强化。
结果：随访6个月内，患者胆囊收缩功能正常,没有不适，也没有复发。术后1周病灶缩小率达到100%。
结论：超声引导经皮微波消融术治疗胆囊息肉不仅保留了胆囊，而且使息肉失活，而不影响胆囊的收缩功能，为胆囊息肉的治疗提供了新思路。
方法：一名72岁女性患者先前诊断为胆囊息肉，但没有认真对待。最近,患者偶尔有右上腹部不适和希望保留胆囊。
方法：超声显示胆囊有中度高回声乳头状突起，后面无回声，改变的位置没有移动。超声造影（CEUS）无恶性征象。诊断为胆囊息肉。
方法：在实时超声引导下引流胆汁并固定引流管，然后将胆囊腔冲洗并填充。在胆囊浆液层和粘膜层之间注射盐水，形成“水肿带”，以保护胆囊壁。然后，在超声引导下对胆囊息肉进行活检，并进行组织学检查。最后,在实时超声引导下将微波针插入目标区域，消融3分钟(20W)。术后超声造影：病灶未见明显强化。
结果：随访6个月内，患者胆囊收缩功能正常,没有不适，也没有复发。术后1周病灶缩小率达到100%。
结论：超声引导经皮微波消融术治疗胆囊息肉不仅保留了胆囊，而且使息肉失活，而不影响胆囊的收缩功能，为胆囊息肉的治疗提供了新思路。
