Clinical application of percutaneous ultrasonography-guided gallbladder polyp biopsy and radiofrequency ablation: a primary study / 中华超声影像学杂志

ABSTRACT

Objective:To analyze the feasibility and efficacy of ultrasound-guided percutaneous biopsy and radiofrequency ablation of gallbladder polyps.Methods:From April 2019 to January 2021, 25 patients with gallbladder polyps underwent ultrasound-guided biopsy and radiofrequency ablation in the ultrasound department of the First Affiliated Hospital of Zhengzhou University were collected, the maximum diameter of the lesion was 11.00(10.00, 12.50)mm. Under general anesthesia, ultrasound-guided injection of water into the gallbladder serosa layer was performed to make the gallbladder edema thicker than or equal to 10 mm. Percutaneous biopsy and radiofrequency ablation of gallbladder polyps were performed to ablate the gallbladder mucosa layer of polyps and polyp attachment.Intraoperative contrast-enhanced ultrasound was used to evaluate the need for supplementary ablation.The operation time, intraoperative and postoperative conditions were recorded. The complete ablation rate of gallbladder polyps, the reduction rate of lesion volume after ablation, the incidence of complications and the effect of operation on gallbladder wall thickness and gallbladder contraction rate were evaluated.Results:Biopsy and radiofrequency ablation of gallbladder polyps were successfully performed in 25 patients.There were 14 cases of cholesterol polyp, 5 cases of adenoma, 5 cases of inflammatory polyp and 1 case of gallbladder adenomyosis. Twenty-nine gallbladder polyps showed changes after ablation, and the lesion volume was reduced to varying degrees. In the first, third and sixth months, the volume reduction rates of ablation focus were 70.74%(58.55%, 77.56%), 89.47%(85.04%, 96.87%) and 100%(95.68%, 100%) respectively, and the differences were statistically significant ( P<0.05). There were no significant differences in gallbladder wall thickness and gallbladder contraction rate before and 1 month after operation ( P>0.05). The operation time was 14-39(23.32±6.68)min. During the operation, 3 patients(12.0%) had a decrease in heart rate, 2 patients(8.0%) had mild abdominal pain and 1 patient(4.0%) had obvious abdominal pain, which was relieved after treatment. No bleeding, gallbladder perforation, abdominal infection and other complications occurred. All patients were followed up for 1 to 22 months, with a median of 6 (3, 7) months. No patients were lost or follow-up, polyp recurrence, or new polyps, or secondary gallstone. Conclusions:Ultrasound-guided biopsy and radiofrequency ablation of gallbladder polyps is a feasible choice for gallbladder preserving treatment of gallbladder polyps with low complication rate.