ENDOSCOPIC TRANSPAPILLARY CATHETERIZATION INTO THE GALLBLADDER FOR DIAGNOSIS OF GALLBLADDER CARCINOMA

Abstract

It is often difficult to determine the precise nature of lesions in the gallbladder by radiographic, endoscopic and ultrasonographic methods. The approach to the gallbladder by a percutaneous transhepatic route has been reported. However, there is a possibility of seeding tumor cells into the peritoneal cavity and liver in a percutaneous procedure. On the contrary, transpapillary route can be performed without a possibility of seeding. The double‐contrast cholecystography, intragallbladder sonography, direct biopsy of gallbladder lesions and cytology using gallbladder bile have been performed by the procedure of the transpapillary catheterization into the gallbladder. Confirming malignancy by histopathological diagnosis is desirous for determining therapeutic strategy in gallbladder carcinoma. Gathering gallbladder bile is comparatively easier than biopsy of the lesion using the transpapillary catheterization into the gallbladder. Examination of telomerase‐related molecules is useful for diagnosis of pancreatic carcinoma. Usefulness of combination assay of human telomerase reverse transcriptase mRNA (hTERT mRNA) and cytology using gallbladder bile obtained by transpapillary catheterization is reported here. However, it would appear that hTERT mRNA is less important in the diagnosis of gallbladder carcinoma than in that of pancreatic carcinoma. When the molecular biological substances with higher sensitivity are found, the reliance of the combination assay of the molecular biological substances and cytology will be established.