Endoscopic sonography in the diagnosis of gallbladder wall lesions in patients with gallstones

Muguruma, Naoki; Okamura, Seisuke; Ichikawa, Soichi; Tsujigami, Koji; Suzuki, Masaharu; Tadatsu, Masaya; Kusaka, Yoshiaki; Okita, Yoshio; Yano, Mitsuyasu; Ito, Susumu

doi:10.1002/jcu.1055

Cited by 16 publications

(6 citation statements)

References 21 publications

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“…Los exámenes de imágenes de la mucosa vesicular en presencia de cálculos no son todo lo sensible y específicos que pudiésemos esperar [28][29][30] . Hay trabajos que demuestran un alto grado de error en la evaluación de este tipo de lesiones, lo que pudiese inducir a una decisión errónea 29,31 .…”

Section: Discussionunclassified

Pólipos y adenomas de la vesícula biliar: consideraciones clínico-patológicas

et al. 2004

Rev. méd. Chile

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Clinicopathological features of gallbladder polyps and adenomas Background: Chile has a high frequency of gallbladder cancer. Polyps are common lesions of gallbladder mucosa but there is little information about their morphological features. Aim: To report the clinical and pathological features of 219 gallbladder polyps. Material and methods: Cholecystectomies samples in which a polypoid lesion was diagnosed microscopically. In all cases, complete clinical information and digitalized images of the complete surgical specimens was reviewed. Results: In a period of 10 years, 21.412 gallbladders were processed. Among these, 884 carcinomas were diagnosed and in 219 cases (1%) a polyp was found. One hundred and eighty three patients were females (mean age 49.3 years) and 36 males (mean age 53.4 years). The preoperative diagnosis of gallbladder polyp was done only in 26 cases (12%). Eighty five percent of polyps were non-neoplastic (metaplastic in 32%, cholesterol in 29%, hyperplastic in 22% and inflammatory in 2%). The remaining 15% were adenomas. Seventy five percent of non-neoplastic polyps were located in the proximal half of the gallbladder and 88% of adenomas in the distal half. Ninety five percent of non-neoplastic polyps measured less than 10 mm. Among adenomas, 47% measured less than 5 mm and 28% more than 10 mm. Smaller polyps were of cholesterol and larger polyps were adenomas. Eight adenomas were associated with an adenocarcinoma, two had less than 5 mm lenght. Mean age of patients with adenomas associated to cancer was higher than patients with pure adenomas (64.6 and 44.3 years respectively, p >0.001). Conclusions: There are size and location differences between non neoplastic polyps and adenomas. Adenomas associated to cancer may measure less than 5 mm. Therefore the polyp size criteria to decide surgical behavior in symptomatic gallstone patients may be misleading (Rev Méd Chile 2004; 132: 673-9).

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Section: Discussionunclassified

Pólipos y adenomas de la vesícula biliar: consideraciones clínico-patológicas

et al. 2004

Rev. méd. Chile

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“…Despite the high malignancy of this tumor, ultrasound is important since it may facilitate treatment if the examiner is cautious to pay attention in the presence of a gallbladder wall mass that fortuitously does not spread out of the gallbladder. Significant help is provided in this case by performing endoscopic or laparoscopic ultrasonography of the gallbladder; however, this modality is of course less widely available than transabdominal ultrasound and experience is still growing out of reference centers [40,41,42,43].…”

Section: Carcinomamentioning

confidence: 97%

Ultrasound of the gallbladder and the biliary tree

2001

Eur Radiol

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“…In unklaren Fällen kann die Endosonografie zur Differenzialdiagnose von Gallenblasenveränderungen herangezogen werden. Gerade bei kleinen Läsionen kann mittels EUS besser als mit der transabdominellen Sonografie zwischen Cholesterolpolypen und Adenomen unterschieden werden [460,461]. Zudem weisen kleinere Studien darauf hin, dass endosonografisch eine extrahepatische PSC bei Wandverdickung ≥ 1,5 mm, irregulären DHC-Wandveränderungen oder Kalibersprüngen und Lymphknoten > 1 cm im Leberhilus vermutet werden kann [462].…”

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