Ultrasonographic detection of early and curable carcinoma of the gallbladder

Koga, Akitoshi; Yamauchi, Shoichiro; Izumi, Yasuharu; Hamanaka, Nobuyuki

doi:10.1002/bjs.1800720919

Cited by 56 publications

(20 citation statements)

References 10 publications

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“…21 The observation of the natural history of PLGs in one study showed that 95% of the lesions with a probable diagnosis of cholesterol polyps remained the same size or were shown to be benign lesions after cholecystectomy; in the other 5%, two thirds turned out to be adenoma or adenocarcinoma when they were resected. 22 The probable relationship between gallbladder adenoma and adenocarcinoma has been sustained by several authors, including Kosuka and others, 13,23 who in the histopathologic analysis of resected gallbladders determined the presence of transition from adenoma to carcinoma, the association of all carcinomas in situ with adenomas, the high frequency of residual adenoma in patients with invasive carcinoma, and an increase in size of lesions transforming from adenoma to carcinoma (benign adenomas were Ͻ12 mm, adenomas with carcinoma in situ were Ͼ12 mm, and invasive carcinomas were Ͼ30 mm). Koga et al 10 made a comparative analysis between benign and malignant lesions and found that 94% of benign lesions are smaller than 10 mm, whereas 88% of malignant lesions are larger than 10 mm.…”

Section: Discussionmentioning

confidence: 99%

Late Follow-Up of Polypoid Lesions of the Gallbladder Smaller Than 10 mm

Csendes¹,

Burgos²,

Csendes³

et al. 2001

Annals of Surgery

101

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ObjectiveTo determine the variation in number, size, and symptoms in patients with polypoid lesions of the gallbladder. Summary Background DataA polypoid lesion is any elevated lesion of the gallbladder mucosa. Several studies have been reported in patients undergoing cholecystectomy, but little information exits regarding the natural history of these lesions in nonoperated patients. MethodsA total of 111 patients with ultrasound diagnosis of polypoid lesions smaller than 10 mm were followed up by clinical evaluation and ultrasonography. Twenty-seven patients underwent cholecystectomy. ResultsThere was no difference in terms of gender. Nearly 80% of the lesions were smaller than 5 mm; they were single in 74%. In nonoperated patients, 50% remained of similar size at the late follow-up, 26.5% increased in number and size, and 23.5% shrank or disappeared. Among the operated patients, 70% corresponded to cholesterol polyps. None of the patients developed symptoms of biliary disease or gallstones or adenocarcinoma. ConclusionsUltrasound is useful in the follow-up of patients with polypoid lesions of the gallbladder. Lesions smaller than 10 mm do not progress to malignancy or to development of stones, and none produced symptoms or complications of biliary disease.

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Section: Discussionmentioning

confidence: 99%

Late Follow-Up of Polypoid Lesions of the Gallbladder Smaller Than 10 mm

Csendes¹,

Burgos²,

Csendes³

et al. 2001

Annals of Surgery

101

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“…It is well known that in the almost cases, the surgeon can perfectly suspect this cancer after opening the gallbladder. It is macroscopically apparent on the mucosa of the gallbladder in almost cases [2,3,6,7,11,12]. In our series, it was the case (macroscopically visible) in 29 cases (87.8%) after the opening of the gallbladder by the surgeon.…”

Section: Discussionmentioning

confidence: 44%

“…The prognosis of this form of gallbladder cancer is excellent with a cholecystectomy [2,11,14,16,18] and radical cholecystectomy. The 5 year survival fluctuates between 70% and 100% [2,7,8,11,14,[16][17][18][19][20][21]26]. In our experience, we encountered one death (radical cholecystectomy) not related to the surgery (myocardial infarction).…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, it represents a proportion of all gallbladder cancer which could be easily cured. In spite of modern morphologic examination and specifically an ultrasonography since twenty years, there is not a clear improvement in the diagnosis for this disease [2][3][4]. This form is often diagnosed after histological examination of specimen removed for biliary lithiasis.…”

Section: Introductionmentioning

confidence: 99%

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Early Gallbladder Cancer: Clinical, Morphological, Therapeutic and Evolutionary Aspects

Salah¹,

Abid²

2013

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Introduction:The early cancer of gallbladder is an entity which is not well recognized currently. It is a cancer which does not extend beyond the muscularis layer of the gallbladder and it is characterized in almost of cases by the absence of lymph node and visceral invasion. Patients and Method: We have conducted this retrospective study of all our cases of early gallbladder cancer treated in our surgical unit. We have studied these through clinical, morphological, therapeutical and evolutionary aspects. Results: Of 202 gallbladder carcinoma, 33 cancers were classified as early cancer. 25 were females and 8 were males. The mean age was 56.4 years (41 -70 years). All patients were free of gallbladder cancer symptoms and all except one had normal CEA and CA19.9. 2 patients had synchronous tumors (one colonic cancer and one rectal cancer). For 16 patients, the diagnosis was done by ultrasonography and 17 by histological examination of the specimen removed for biliary lithiasis. 8 patients had PT1a tumor (confined only to mucosa) and 25 had PT1b tumor (tumor infiltration of the muscular layer). For 19 patients who benefited from extensive lymphadenectomy, only one (5.3%) had lymph node infiltration. 16 patients had a simple cholecystectomy and in two cases, the cholecystectomy was associated with bile duct resection. 17 patients had hepatectomy with extensive lymphadenectomy. 2 patients had a simultaneous right colectomy and abdominoperineal resection and another one benefited from choledocal cyst resection. 3 patients benefited from stone removal from bile duct and two had tumor removal from bile duct (ruptured tumor in the bile duct). 1 patient (3.7%) died in postoperative course (hospital mortality). In the follow-up period, 4 patients died from intercurrent causes. Two patients presented a recurrence at 14 and 36 months and died respectively at 19 and 42 months. One patient presented a bile duct cancer at 66 months. She died at 78 months after palliative treatment. Currently, 22 patients (66.7%) are still alive without recurrence with mean and median survival of 53 and 31 months. Conclusion: Early gallbladder cancer is an entity which must be known by the radiologist and the surgeon. Recognized on time and well treated, early gallbladder cancer can be cured and its prognosis is excellent.

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“…According to Piehler and Crichlow [1], the surgeon will encounter cancer in approximately 1.9% of the operations of the biliary tract. Ultrasound helps in early detection and treatment of gall bladder cancer [2], Most patients are operated upon with a preoperative sonographic diagnosis of gallstones or acute cholecystitis, the operative finding being extensive carcinoma of the gallbladder, sometimes with massive hepatic involvement. Though ultrasound is the imaging tool most widely used, other techniques include com puted tomography (CT), percutaneous transhepatic chol angiography (PTC) and endoscopic retrograde cholangio Normal values: bilirubin < 1.0 mg%; LDH <225 U/l; SGOT <40 U/l.…”

Section: Introductionmentioning

confidence: 99%

Carcinoma of the Gallbladder: Diagnosis, Treatment, Prognosis

Watemberg¹,

Avrahami²,

Landau³

et al. 1993

Dig Surg

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Despite modern imaging techniques, the majority of gallbladder cancers are recognized at the time of laparotomy, when curative procedures are rarely possible. Predisposing factors include old age, female sex and cholelithiasis. Abdominal pain, vomiting, anorexia, weight loss and jaundice are the most prevalent signs and symptoms. The nonspecific clinical picture combined with low sonographic diagnostic value make preoperative diagnosis unlikely. The very low survival rates, with or without surgery, dictate a more palliative approach. Palliation includes primarily the relief of pain, jaundice and intestinal obstruction. Between 1987 and 1992, we have treated 21 patients with gallbladder carcinoma. The following paper reviews these cases in light of the current literature.

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Ultrasonographic detection of early and curable carcinoma of the gallbladder

Cited by 56 publications

References 10 publications

Late Follow-Up of Polypoid Lesions of the Gallbladder Smaller Than 10 mm

Late Follow-Up of Polypoid Lesions of the Gallbladder Smaller Than 10 mm

Early Gallbladder Cancer: Clinical, Morphological, Therapeutic and Evolutionary Aspects

Carcinoma of the Gallbladder: Diagnosis, Treatment, Prognosis

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