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The role of endoscopic ultrasound in the diagnosis of gallbladder diseases

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Abstract

Endoscopic ultrasound (EUS) has recently played an increasing role in the diagnosis of gallbladder diseases. This review aims to summarize the role of EUS in the diagnosis of gallbladder lesions. EUS provides high-resolution images that can improve the diagnosis of gallbladder polypoid lesions and microlithiasis, in addition to evaluating gallbladder thickness and staging of gallbladder carcinoma. Contrast-enhancing agents may be useful for the differential diagnosis of gallbladder lesions, but the evidence of their effectiveness is still limited and further studies are required in this area to establish its usefulness. Endoscopic ultrasound combined with fine needle aspiration has played an increasing role in providing histological diagnosis of gallbladder tumors in addition to gallbladder thickening.

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References

  1. Stinton LM, Shaffer EA. Epidemiology of gallbladder disease: cholelithiasis and cancer. Gut Liver. 2012;6:172–87.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Kanthan R, Senger JL, Ahmed S, et al. Gallbladder cancer in the twenty first century. J Oncol. 2015;2015:967472.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Zhu AX, Hong TS, Hezel AF, et al. Current management of gallbladder carcinoma. Oncologist. 2010;15:168–81.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Chattopadhyay D, Lochan R, Balupuri S, et al. Outcome of gall bladder polypoidal lesions detected by transabdominal ultrasound scanning: a 9 year experience. World J Gastroenterol. 2005;11:2171–3.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Yang HL, Sun YG, Wang Z. Polypoid lesions of the gallbladder: diagnosis and indications for surgery. Br J Surg. 1992;79:227–9.

    Article  CAS  PubMed  Google Scholar 

  6. Terzi C, Sokmen S, Seckin S, et al. Polypoid lesions of the gallbladder: report of 100 cases with special reference to operative indications. Surgery. 2000;127:622–7.

    Article  CAS  PubMed  Google Scholar 

  7. Dahan P, Andant C, Levy P, et al. Prospective evaluation of endoscopic ultrasonography and microscopic examination of duodenal bile in the diagnosis of cholecystolithiasis in 45 patients with normal conventional ultrasonography. Gut. 1996;38:277–81.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Sugiyama M, Xie XY, Atomi Y, et al. Differential diagnosis of small polypoid lesions of the gallbladder: the value of endoscopic ultrasonography. Ann Surg. 1999;229:498–504.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Azuma T, Yoshikawa T, Araida T, et al. Differential diagnosis of polypoid lesions of the gallbladder by endoscopic ultrasonography. Am J Surg. 2001;181:65–70.

    Article  CAS  PubMed  Google Scholar 

  10. Cheon YK, Cho WY, Lee TH, et al. Endoscopic ultrasonography does not differentiate neoplastic from non-neoplastic small gallbladder polyps. World J Gastroenterol. 2009;15:2361–6.

    Article  PubMed  PubMed Central  Google Scholar 

  11. 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;46:250–4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Jang JY, Kim SW, Lee SE, et al. Differential diagnostic and staging accuracies of high resolution ultrasonography, endoscopic ultrasonography, and multidetector computed tomography for gallbladder polypoid lesions and gallbladder cancer. Ann Surg. 2009;250:943–9.

    Article  PubMed  Google Scholar 

  13. Bang SH, Lee JY, Woo H, et al. Differentiating between adenomyomatosis and gallbladder cancer: revisiting a comparative study of high-resolution ultrasound, multidetector CT, and MR imaging. Korean J Radiol. 2014;15:226–34.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Ardengh JC, Malheiros CA, Rahal F, et al. Microlithiasis of the gallbladder: role of endoscopic ultrasonography in patients with idiopathic acute pancreatitis. Rev Assoc Med Bras. 2010;56:27–31.

    Article  PubMed  Google Scholar 

  15. Mirbagheri SA, Mohamadnejad M, Nasiri J, et al. Prospective evaluation of endoscopic ultrasonography in the diagnosis of biliary microlithiasis in patients with normal transabdominal ultrasonography. J Gastrointest Surg. 2005;9:961–4.

    Article  PubMed  Google Scholar 

  16. Thorboll J, Vilmann P, Jacobsen B, et al. Endoscopic ultrasonography in detection of cholelithiasis in patients with biliary pain and negative transabdominal ultrasonography. Scand J Gastroenterol. 2004;39:267–9.

    Article  CAS  PubMed  Google Scholar 

  17. Ito H, Hann LE, D’Angelica M, et al. Polypoid lesions of the gallbladder: diagnosis and followup. J Am Coll Surg. 2009;208:570–5.

    Article  PubMed  Google Scholar 

  18. Mellnick VM, Menias CO, Sandrasegaran K, et al. Polypoid lesions of the gallbladder: disease spectrum with pathologic correlation. Radiographics. 2015;35:387–99.

    Article  PubMed  Google Scholar 

  19. van Breda Vriesman AC, Engelbrecht MR, Smithuis RH, et al. Diffuse gallbladder wall thickening: differential diagnosis. AJR Am J Roentgenol. 2007;188:495–501.

    Article  PubMed  Google Scholar 

  20. Akatsu T, Aiura K, Shimazu M, et al. Can endoscopic ultrasonography differentiate nonneoplastic from neoplastic gallbladder polyps? Dig Dis Sci. 2006;51:416–21.

    Article  PubMed  Google Scholar 

  21. Cho JH, Park JY, Kim YJ, et al. Hypoechoic foci on EUS are simple and strong predictive factors for neoplastic gallbladder polyps. Gastrointest Endosc. 2009;69:1244–50.

    Article  PubMed  Google Scholar 

  22. Kimura K, Fujita N, Noda Y, et al. Differential diagnosis of large-sized pedunculated polypoid lesions of the gallbladder by endoscopic ultrasonography: a prospective study. J Gastroenterol. 2001;36:619–22.

    Article  CAS  PubMed  Google Scholar 

  23. Muguruma N, Okamura S, Ichikawa S, et al. Endoscopic sonography in the diagnosis of gallbladder wall lesions in patients with gallstones. J Clin Ultrasound. 2001;29:395–400.

    Article  CAS  PubMed  Google Scholar 

  24. Choi WB, Lee SK, Kim MH, et al. A new strategy to predict the neoplastic polyps of the gallbladder based on a scoring system using EUS. Gastrointest Endosc. 2000;52:372–9.

    Article  CAS  PubMed  Google Scholar 

  25. Sadamoto Y, Oda S, Tanaka M, et al. A useful approach to the differential diagnosis of small polypoid lesions of the gallbladder, utilizing an endoscopic ultrasound scoring system. Endoscopy. 2002;34:959–65.

    Article  CAS  PubMed  Google Scholar 

  26. Hirooka Y, Naitoh Y, Goto H, et al. Contrast-enhanced endoscopic ultrasonography in gallbladder diseases. Gastrointest Endosc. 1998;48:406–10.

    Article  CAS  PubMed  Google Scholar 

  27. Choi JH, Seo DW, Park do H, et al. Utility of contrast-enhanced harmonic EUS in the diagnosis of malignant gallbladder polyps (with videos). Gastrointest Endosc. 2013;78:484–93.

    Article  PubMed  Google Scholar 

  28. Park CH, Chung MJ, Oh TG, et al. Differential diagnosis between gallbladder adenomas and cholesterol polyps on contrast-enhanced harmonic endoscopic ultrasonography. Surg Endosc. 2013;27:1414–21.

    Article  PubMed  Google Scholar 

  29. Liu LN, Xu HX, Lu MD, et al. Contrast-enhanced ultrasound in the diagnosis of gallbladder diseases: a multi-center experience. PLoS One. 2012;7:e48371.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Xie XH, Xu HX, Xie XY, et al. Differential diagnosis between benign and malignant gallbladder diseases with real-time contrast-enhanced ultrasound. Eur Radiol. 2010;20:239–48.

    Article  PubMed  Google Scholar 

  31. Yuan HX, Cao JY, Kong WT, et al. Contrast-enhanced ultrasound in diagnosis of gallbladder adenoma. Hepatobiliary Pancreat Dis Int. 2015;14:201–7.

    Article  PubMed  Google Scholar 

  32. Kim HJ, Park JH, Park DI, et al. Clinical usefulness of endoscopic ultrasonography in the differential diagnosis of gallbladder wall thickening. Dig Dis Sci. 2012;57:508–15.

    Article  PubMed  Google Scholar 

  33. Imazu H, Mori N, Kanazawa K, et al. Contrast-enhanced harmonic endoscopic ultrasonography in the differential diagnosis of gallbladder wall thickening. Dig Dis Sci. 2014;59:1909–16.

    Article  PubMed  Google Scholar 

  34. Mizuguchi M, Kudo S, Fukahori T, et al. Endoscopic ultrasonography for demonstrating loss of multiple-layer pattern of the thickened gallbladder wall in the preoperative diagnosis of gallbladder cancer. Eur Radiol. 1997;7:1323–7.

    Article  CAS  PubMed  Google Scholar 

  35. Sugimoto M, Takagi T, Konno N, et al. The efficacy of contrast-enhanced harmonic endoscopic ultrasonography in diagnosing gallbladder cancer. Sci Rep. 2016;6:25848.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Mitake M, Nakazawa S, Naitoh Y, et al. Endoscopic ultrasonography in diagnosis of the extent of gallbladder carcinoma. Gastrointest Endosc. 1990;36:562–6.

    Article  CAS  PubMed  Google Scholar 

  37. Sadamoto Y, Kubo H, Harada N, et al. Preoperative diagnosis and staging of gallbladder carcinoma by EUS. Gastrointest Endosc. 2003;58:536–41.

    Article  PubMed  Google Scholar 

  38. Fujita N, Noda Y, Kobayashi G, et al. Diagnosis of the depth of invasion of gallbladder carcinoma by EUS. Gastrointest Endosc. 1999;50:659–63.

    Article  CAS  PubMed  Google Scholar 

  39. Jacobson BC, Pitman MB, Brugge WR. EUS-guided FNA for the diagnosis of gallbladder masses. Gastrointest Endosc. 2003;57:251–4.

    Article  PubMed  Google Scholar 

  40. Varadarajulu S, Eloubeidi MA. Endoscopic ultrasound-guided fine-needle aspiration in the evaluation of gallbladder masses. Endoscopy. 2005;37:751–4.

    Article  CAS  PubMed  Google Scholar 

  41. Hijioka S, Mekky MA, Bhatia V, et al. Can EUS-guided FNA distinguish between gallbladder cancer and xanthogranulomatous cholecystitis? Gastrointest Endosc. 2010;72:622–7.

    Article  PubMed  Google Scholar 

  42. Ogura T, Kurisu Y, Masuda D, et al. Can endoscopic ultrasound-guided fine needle aspiration offer clinical benefit for thick-walled gallbladders? Dig Dis Sci. 2014;59:1917–24.

    Article  PubMed  Google Scholar 

  43. Hijioka S, Hara K, Mizuno N, et al. Diagnostic yield of endoscopic retrograde cholangiography and of EUS-guided fine needle aspiration sampling in gallbladder carcinomas. J Hepatobiliary Pancreat Sci. 2012;19:650–5.

    Article  PubMed  Google Scholar 

  44. Jacobson BC, Waxman I, Parmar K, et al. Endoscopic ultrasound-guided gallbladder bile aspiration in idiopathic pancreatitis carries a significant risk of bile peritonitis. Pancreatology. 2002;2:26–9.

    Article  PubMed  Google Scholar 

  45. Samad A, Kaplan A, Arain M, et al. Endoscopic ultrasound-guided fine-needle aspiration diagnosis of large cell neuroendocrine carcinoma of the gallbladder and common bile duct: report of a case. Diagn Cytopathol. 2013;41:1091–5.

    Article  PubMed  Google Scholar 

  46. Chambers MR, Hasan MK, Hebert-Magee S. Pearls before bile: primary squamous cell carcinoma of the gallbladder diagnosed on-site by endoscopic ultrasound-guided fine-needle aspiration. Dig Endosc. 2016;28:105.

    Article  PubMed  Google Scholar 

  47. St Romain P, Desai S, Bean S, et al. Extramedullary plasmacytoma of the gallbladder diagnosed by endoscopic ultrasound fine needle aspiration (EUS-FNA). J Gastrointest Oncol. 2015;6:E7–9.

    PubMed  PubMed Central  Google Scholar 

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Acknowledgments

The authors would like to thanks Dr. Brett Ibbeson for the English proofreading of the manuscript.

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Correspondence to Yoshiki Hirooka.

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The authors disclose no conflicts of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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Chantarojanasiri, T., Hirooka, Y., Kawashima, H. et al. The role of endoscopic ultrasound in the diagnosis of gallbladder diseases. J Med Ultrasonics 44, 63–70 (2017). https://doi.org/10.1007/s10396-016-0742-9

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  • DOI: https://doi.org/10.1007/s10396-016-0742-9

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