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Diagnostic yield of endoscopic retrograde cholangiography and of EUS-guided fine needle aspiration sampling in gallbladder carcinomas

  • Original article
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Journal of Hepato-Biliary-Pancreatic Sciences

Abstract

Background

Obtaining histological evidence of gallbladder carcinoma (GBC) is difficult due to its extraductal nature, and pathological confirmation remains challenging. We compared the diagnostic value and safety of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) with endoscopic retrograde cholangiography (ERC) in patients with suspected GBC.

Patients

Eighty-three patients with GBC were evaluated. Prior to definitive management, pathological evidence of GBC was obtained through either ERC cytopathologic sampling (n = 33), EUS-FNA (n = 24) or both (n = 26).

Results

Among the 83 patients, 59 (71.0%) with biliary obstruction were sampled using ERC with 47.4% (28/59) sensitivity. In 19 of the remaining 31 cases, EUS-FNA sampling had 100% diagnostic sensitivity. Likewise, 50 (60.2%) of the 83 patients with suspected GBC underwent EUS-FNA of regional lymph nodes or the gallbladder (GB) mass itself with 94.8% sensitivity. The overall diagnostic sensitivity rates of ERC and EUS-FNA were 47.4 and 96%, respectively (P < 0.001). Post-procedural complications were seen in 6.7% of the ERC group (4/59, all were mild pancreatitis), and in none of the EUS-FNA group (P = 0.10).

Conclusions

Gallbladder carcinoma sampling using ERC and EUS-FNA should be incorporated into the diagnostic workup of GB lesions as complementary tools, and EUS-FNA should be applied in the setting of failed or not indicated ERC.

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Authors and Affiliations

  1. Department of Gastroenterology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi, 464-8681, Japan

    Susumu Hijioka, Kazuo Hara, Nobumasa Mizuno, Hiroshi Imaoka, Takeshi Ogura, Shin Haba & Kenji Yamao

  2. Department of Tropical Medicine and Gastroenterology, Assiut University Hospital, Assiut, Egypt

    Mohamed A. Mekky

  3. Department of Medical Hepatology, Institute of Liver and Biliary Sciences (ILBS), Delhi, India

    Vikram Bhatia

  4. Department of Pathology and Molecular Diagnostics, Aichi Cancer Center Hospital, Nagoya, Japan

    Waki Hosoda & Yasushi Yatabe

  5. Department of Surgery, Aichi Cancer Center Hospital, Nagoya, Japan

    Yasuhiro Shimizu

  6. Department of Endoscopy, Aichi Cancer Center Hospital, Nagoya, Japan

    Yasumasa Niwa, Masahiro Tajika, Shinya Kondo & Tsutomu Tanaka

  7. Department of Gastroenterology, Jichi Medical University, Tochigi, Japan

    Kiichi Tamada

Authors
  1. Susumu Hijioka
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  2. Kazuo Hara
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  3. Nobumasa Mizuno
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  4. Hiroshi Imaoka
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  5. Takeshi Ogura
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  6. Shin Haba
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  7. Mohamed A. Mekky
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  8. Vikram Bhatia
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  9. Waki Hosoda
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  10. Yasushi Yatabe
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  11. Yasuhiro Shimizu
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  12. Yasumasa Niwa
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  13. Masahiro Tajika
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  14. Shinya Kondo
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  15. Tsutomu Tanaka
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  16. Kiichi Tamada
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  17. Kenji Yamao
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Corresponding author

Correspondence to Susumu Hijioka.

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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 19, 650–655 (2012). https://doi.org/10.1007/s00534-011-0482-6

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  • DOI: https://doi.org/10.1007/s00534-011-0482-6

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