Usage of ultrasonography in gallbladder lesions. Analysis of 85 cases: a single centre study

Abstract

Background: The differential diagnosis of gallbladder (Gb) lesions is challenging. The aim of the present study was to evaluated the clinical usefulness of abdominal ultrasonography (US) for differential diagnosis of gallbladder lesions. Methods: We retrospectively assessed US images and pathology reports of 85 patients (57 women, age 63.4±11.2 years) who were admitted to our clinic between January 2014 and December 2017 with primary diagnosis of Gb lesion. Results: All patients at admission had US examination, which resulted in suspicion of different stages of Gb cancer in 63 cases (74.1%), benign Gb lesions in 10 cases (11.8%), biliary duct cancer (BTC) in 3 cases (3.5%) and uncertain diagnosis in 9 cases (10.6%). The correlation of US and histopathology results showed 73.0% compatibility, 16.4% discrepancy and 10.6% uncertainty. Among correct US diagnosis Gb cancer was confirmed in 52 cases (82.5%). Statistical analysis showed significant difference in Gb wall thickness between correctly diagnosed Gb cancer and benign Gb lesion groups (p = 0.001). In descriptive analysis other misdiagnosed features that mimicked Gb cancer were analysed, such as: pathologically changed Gb wall; liver, common hepatic duct (CHD) or other surrounding tissues infiltration; enlargement of lymph nodes. Conclusion: US examination has high sensitivity for detection of advanced Gb cancer what can facilitate treatment decision. Thickness of the Gb wall can be an important factor for distinguishing benign and cancerous process. Misdiagnosis of Gb cancer and BTC is possible when tumor mass is in the middle part of CHD or within liver parenchyma and infiltrate the Gb.