Gallbladder Region Research Articles

A Medium-Term Comparison of Quality of Life and Pain After Robotic or Laparoscopic Cholecystectomy

IntroductionWe sought to compare medium-term outcomes between robotic-assisted cholecystectomy (RC) and laparoscopic cholecystectomy (LC) using validated quality of life (QoL) and pain assessments. Materials and MethodsPatients who underwent RC or LC between 2012 and 2017 at a single academic institution were examined. Cases converted to open were excluded. Patients were contacted by telephone in 2019 and completed two standardized surveys to rate their QoL and pain. ResultsOf those screened, 122 (35.8%) completed both surveys. Ninety three (76.2%) underwent RC and 29 (23.8%) underwent LC. The groups (RC versus LC) were similar based on mean age (47.9 versus 45.5 y, P = 0.48), gender (66.7% versus 72.4% female, P = 0.56), race (86.0% White/5.4% Black versus 72.4% White/13.8% Black, P = 0.2), insurance status (98.9% versus 100.0% insured, P = 0.58), median body mass index (31.8 versus 31.3, P = 0.43), and median Charlson Comorbidity Index (1 versus 0, P = 0.14). Fewer RC patients had a history of steroid use compared to LC (16.1% versus 34.5%, P = 0.03). No overall significant difference in QoL was demonstrated. LC group had higher severity of “tiring-exhausting pain” (P = 0.04), “electric-shock pain” (P = 0.003), and “shooting pain” (P = 0.05). The “overall intensity” of pain in the “gallbladder region” between the groups was similar at the time of follow-up (P = 0.31). ConclusionsQoL over 2-7 y following time of surgery is comparable for robotic-assisted versus conventional laparoscopic cholecystectomies. The laparoscopic approach may be associated with a higher severity of subset categories of pain, but overall pain between the two approaches is comparable.

Increased radiographic opacity in the region of the gallbladder can be identified in dogs with large amounts of gallbladder sediment, sludge balls, and gallbladder mucocele.

Increased soft-tissue opacity in the region of the canine gallbladder is incidentally detected on radiographs. We hypothesized that there is a difference in the detection of gallbladder sediment on radiographs depending on the amount or mobility of the sediment. In this retrospective and analytical study, we aimed to assess the ultrasonographic features of gallbladder sediment that were detected radiographically. We also aimed to assess the differences in the detection of increased opacity of the gallbladder between radiographic views. We included 223 dogs that underwent thoracic radiography, abdominal radiography, and gallbladder ultrasonography. Ultrasonographic images of the gallbladder were divided into five groups: group 1, gravity-dependent sediment occupying<50% of the gallbladder; group 2, gravity-dependent sediment occupying ≥50%; group 3, sediment attached to the gallbladder wall; group 4, sludge ball; and group 5, gallbladder mucocele. Dogs showing increased opacity on subjective assessment of any radiographic view were recorded, and the sensitivity of radiographic views for detecting gallbladder sediment was analyzed. Of 168 dogs with gallbladder sediment, 37 had increased opacity on at least one radiographic projection. The frequency was compared as a percentage within each category, and Group 4 was the highest percentage with increased radiographic gallbladder opacity, followed by Groups 2 and 5. The sensitivity for detecting increased opacity was highest in the thoracic ventrodorsal view. Thus, in dogs with increased gallbladder opacity on radiographs, large amounts of gallbladder sediment, sludge balls, and gallbladder mucocele should be considered differential diagnoses. In addition, the thoracic ventrodorsal view is recommended to evaluate gallbladder opacity.

Multiple instance convolutional neural network for gallbladder assessment from laparoscopic images.

We present an artificial intelligence framework for vascularity classification of the gallbladder (GB) wall from intraoperative images of laparoscopic cholecystectomy (LC). A two-stage Multiple Instance Convolutional Neural Network is proposed. First, a convolutional autoencoder is trained to extract feature representations from 4585 patches of GB images. The second model includes a multi-instance encoder that fetches random patches from a GB region and outputs an equal number of embeddings that feed a multi-input classification module, which employs pooling and self-attention mechanisms, to perform prediction. The evaluation was performed on 234GB images of low and high vascularity from 68 LC videos. Thorough comparison with various state-of-the-art multi-instance and single-instance learning algorithms was performed for two experimental tasks: image- and video-level classification. The proposed framework shows the best performance with accuracy 92.6%-93.2% and F1 93.5%-93.9%, close to the agreement of two expert evaluators (94%). The proposed technique provides a novel approach to classify LC operations with respect to the vascular pattern of the GB wall.

Study of anatomic variations of human gall bladder and its clinical importance

Introduction: One of the most important and commonly performed surgeries in the abdominal region is the surgery of gall bladder. Hence it is desirable for the surgeons who are operating in the region of gall bladder and biliary tract to know the possible variations in the anatomy of gall bladder that can be confronted. The present study describes the anatomic variations of gall bladder and its clinical importance. Materials and Methods: 50 gall bladder specimens procured from embalmed human adult cadavers of both sexes available in Anatomy Department of MVJ Medical College, Bangalore were studied. The different parameters studied were the measurements of gall bladder which included its length & breadth, shape, position & external variations. Results: The mean length and breadth of the gall bladder was found to be 6.79 cm& 2.81 cm respectively. The various shapes of the gall bladder noted were pear shaped (52%), flask shaped (28%), cylindrical (12%), irregular (4%) and hour-glass (4%). In 49(98%) specimens, the position of gall bladder was beneath the right lobe of the liver. Gall bladder was intrahepatic in position in 1 (2%) specimen. The external variations of gall bladder observed in 9(18%) specimens were in the form of folding of the neck, folded fundus (phrygian cap) & hartmann’s pouch. Conclusion: The knowledge of the possible anatomic variations of the gall bladder is of utmost significance to radiologists who should detect them preoperatively using special radiological procedures and to surgeons during laparoscopic cholecystectomy to reduce the incidence of post-operative complications. Keywords: Gall Bladder, Hartmann’s pouch, Morphology, Phrygian cap, Variations.

Patch-based classification of gallbladder wall vascularity from laparoscopic images using deep learning.

In this study, we propose a deep learning approach for assessment of gallbladder (GB) wall vascularity from images of laparoscopic cholecystectomy (LC). Difficulty in the visualization of GB wall vessels may be the result of fatty infiltration or increased thickening of the GB wall, potentially as a result of cholecystitis or other diseases. The dataset included 800 patches and 181 region outlines of the GB wall extracted from 53 operations of the Cholec80 video collection. The GB regions and patches were annotated by two expert surgeons using two labeling schemes: 3 classes (low, medium and high vascularity) and 2 classes (low vs. high). Two convolutional neural network (CNN) architectures were investigated. Preprocessing (vessel enhancement) and post-processing (late fusion of CNN output) techniques were applied. The best model yielded accuracy 94.48% and 83.77% for patch classification into 2 and 3 classes, respectively. For the GB wall regions, the best model yielded accuracy 91.16% (2 classes) and 80.66% (3 classes). The inter-observer agreement was 91.71% (2 classes) and 78.45% (3 classes). Late fusion analysis allowed the computation of spatial probability maps, which provided a visual representation of the probability for each vascularity class across the GB wall region. This study is the first significant step forward to assess the vascularity of the GB wall from intraoperative images based on computer vision and deep learning techniques. The classification performance of the CNNs was comparable to the agreement of two expert surgeons. The approach may be used for various applications such as for classification of LC operations and context-aware assistance in surgical education and practice.

Hepatoid Adenocarcinoma presenting in the colon with an unknown primary: A rare tumor case report

Hepatoid adenocarcinoma (HAC) is a very rare malignant tumor of extrahepatic origin which is characterized by having foci with features of both hepatocellular differentiation as well as adenomatous differentiation. It is most commonly seen in the stomach, however, few cases of HAC originating in the ovary, small intestine, colon, lung, uterus, pancreas, gallbladder, oesophagus and periampullary region have also been reported. Interestingly, it morphologically and functionally resembles Hepatocellular carcinoma, which can make the diagnosis challenging. Identification of HAC is necessary as it is associated with a dismal prognosis. We report here a case of a metastatic hepatoid adenocarcinoma of an unknown primary presenting in the ascending colon with both hepatoid and mucinous adenocarcinomatous areas on morphology. Keywords: Gastrointestinal tract, Hepatic like, Tumor.

Computer-aided diagnosis of gallbladder polyps based on high resolution ultrasonography

Background and objectiveGallbladder polyp is a common disease with an overall population prevalence between 4 and 7%. It can be classified as neoplastic and non-neoplastic lesions. Surgical treatment is necessary for neoplastic polyps. Due to its easy accessibility and nonradioactive, ultrasonography is the mostly used preoperative diagnosis tool for gallbladder polyps. However, human image analysis depends greatly on levels of experience, which results in many overtreatment cases and undertreatment cases in clinics. MethodsIn this study, we proposed an ultrasound image segmentation algorithm, combined with principal components analysis (PCA) and AdaBoost algorithms to construct a computer-aided diagnosis system for the differentiate diagnosis of neoplastic and non-neoplastic gallbladder polyps. ResultsThe proposed segmentation method achieved a high accuracy of 95% for outlining the gallbladder region. The accuracy, sensitivity, specificity for the proposed computer-aided diagnosis system based on the segmented images are 87.54%, 86.52% and 89.40%, compared to 69.05%, 67.86% and 70.17% with convolutional neural network. The diagnosis result is also slightly higher than the human eyes of sonologists (86.22%, 85.19% and 89.18% as an average of four sonologists), while with a much faster diagnosis speed (0.02s vs 3s). ConclusionsWe proposed an efficient ultrasound image segmentation approach and a reliable system of automatic diagonals of neoplastic and non-neoplastic gallbladder polyps. The results show that the diagnosis accuracy is competitive to the expert sonologists while requires much less diagnosis time.

Лапароскопическая холецистэктомия при остром калькулезном холецистите у больных, ранее оперированных на органах брюшной полости

Реферат&#x0D; Цель. Изучение эффективности дооперационной диагностики и лапароскопических методов коррекции спаечной болезни (СБ) у больных с острым калькулезным холециститом (ОКХ).&#x0D; Материалы и методы. Проведен анализ эффективности дооперационной диагностики и лапароскопических методов коррекции СБ у 110 пациентов с ОКХ, ранее перенесших оперативные вмешательства на органах брюшной полости.&#x0D; Результаты. Диагностическая ценность сонографии при СБ высокая. Использование ультразвукового скальпеля (УЗС) у больных с выраженными местными воспалительными изменениями тканей в области желчного пузыря и сопутствующей СБ имеет преимущества.&#x0D; Выводы. Применение УЗС - наиболее эффективный и безопасный метод рассечения спаек и разъединения инфильтрата при ОКХ.

The substantiation of the application of the high-intensity pulsed magnetic field for the combined treatment of biliary sludge

The objective of the present study was to evaluate the effectiveness of the application of the high-intensity pulsed magnetic field in the combination with the intake of mineral water (MW) and rational pharmacotherapy as the components of the combined treatment of biliary sludge. The study included 117 patients presenting with biliary sludge (BS) who were randomly allocated to three groups. Group 1 was comprised of 38 patients and served as the control group. These patients received medicamentous therapy (hymecromone - 200 mg 3 times daily during two weeks and ursodeoxycholic acid at a dose of 10-15 mg/kg a day during a period from 3 to 6 months). The second group consisted of 40 patients and served as the group of comparison. The patients of this group received medicamentous therapy in the combination with the intake of 'Sernovodskaya' hydrocarbonate-chloride-sulphate sodium mineral water (from a spring in the Chechen republic). The third group was composed of 39 patients and constituted the main study group. These patients completed a course of therapy with the use of the high-intensity pulsed magnetic field applied to the gall bladder region. Each patient underwent 10 sessions of magnetic therapy after the completion of the treatment with hymecromone and 'Sernovodskaya' mineral water. The treatment was carried out with simultaneous monitoring dynamics of the clinical symptoms of biliary sludge, the ultrasound examination of the abdominal organs with the evaluation of the contractile function of the gall bladder, the level of bilirubin in the cystic bile, bile acids, cholesterol, and cholate-cholesteric coefficient. The combined treatment of the patients suffering from BS including the application of the high-intensity pulsed magnetic field alleviated the clinical symptoms of the disease much faster than medicamentous therapy combined with the intake of 'Sernovodskaya' mineral water. Moreover, it promoted the restoration of the motor activity of the gall bladder and accelerated the evacuation of the hyperechoic particles. The course of the combined treatment of the patients presenting with biliary sludge including the application of the high-intensity pulsed magnetic field in the combination with the intake of mineral water (MW) and rational pharmacotherapy significantly relieved abdominal pains, alleviated the symptoms of biliary dyspepsia, and improved the motor function of the biliary tract. These therapeutic effects persisted as long as 3 months. The results of the present study give evidence of the necessity of prescription of an optimum dose of ursodeoxycholic acid to the patients suffering from biliary sludge.

Automatic gallbladder segmentation using combined 2D and 3D shape features to perform volumetric analysis in native and secretin-enhanced MRCP sequences.

We aimed to develop the first fully automated 3D gallbladder segmentation approach to perform volumetric analysis in volume data of magnetic resonance (MR) cholangiopancreatography (MRCP) sequences. Volumetric gallbladder analysis is performed for non-contrast-enhanced and secretin-enhanced MRCP sequences. Native and secretin-enhanced MRCP volume data were produced with a 1.5-T MR system. Images of coronal maximum intensity projections (MIP) are used to automatically compute 2D characteristic shape features of the gallbladder in the MIP images. A gallbladder shape space is generated to derive 3D gallbladder shape features, which are then combined with 2D gallbladder shape features in a support vector machine approach to detect gallbladder regions in MRCP volume data. A region-based level set approach is used for fine segmentation. Volumetric analysis is performed for both sequences to calculate gallbladder volume differences between both sequences. The approach presented achieves segmentation results with mean Dice coefficients of 0.917 in non-contrast-enhanced sequences and 0.904 in secretin-enhanced sequences. This is the first approach developed to detect and segment gallbladders in MR-based volume data automatically in both sequences. It can be used to perform gallbladder volume determination in epidemiological studies and to detect abnormal gallbladder volumes or shapes. The positive volume differences between both sequences may indicate the quantity of the pancreatobiliary reflux.

THE CASE FILES

THE CASE FILES

Automatic gallbladder and gallstone regions segmentation in ultrasound image

As gallbladder diseases including gallstone and cholecystitis are mainly diagnosed by using ultra-sonographic examinations, we propose a novel method to segment the gallbladder and gallstones in ultrasound images. The method is divided into five steps. Firstly, a modified Otsu algorithm is combined with the anisotropic diffusion to reduce speckle noise and enhance image contrast. The Otsu algorithm separates distinctly the weak edge regions from the central region of the gallbladder. Secondly, a global morphology filtering algorithm is adopted for acquiring the fine gallbladder region. Thirdly, a parameter-adaptive pulse-coupled neural network (PA-PCNN) is employed to obtain the high-intensity regions including gallstones. Fourthly, a modified region-growing algorithm is used to eliminate physicians' labeled regions and avoid over-segmentation of gallstones. It also has good self-adaptability within the growth cycle in light of the specified growing and terminating conditions. Fifthly, the smoothing contours of the detected gallbladder and gallstones are obtained by the locally weighted regression smoothing (LOESS). We test the proposed method on the clinical data from Gansu Provincial Hospital of China and obtain encouraging results. For the gallbladder and gallstones, average similarity percent of contours (EVA) containing metrics dice's similarity , overlap fraction and overlap value is 86.01 and 79.81%, respectively; position error is 1.7675 and 0.5414mm, respectively; runtime is 4.2211 and 0.6603s, respectively. Our method then achieves competitive performance compared with the state-of-the-art methods. The proposed method is potential to assist physicians for diagnosing the gallbladder disease rapidly and effectively.

Spontaneous biloma: Report of two cases with review of the literature

INTRODUCTION Biloma is the collection of bile outside the biliary tree and can be intra or extra hepatic. It is most commonly iatrogenic, secondary to surgery or percutaneous transhepatic procedures or secondary to abdominal trauma. Spontaneous bilomas are very rarely described in the literature. CASE REPORT A 32 years old female presented as lump abdomen in epigastric region. Blood investigations were normal. Chest radiographs were unremarkable. Ultrasound examination revealed two cystic lesion in relation to left lobe of liver and cholelithiasis with choledocholithiasis. Ultrasound guided pigtail catheter drainage of the collection was done. ERCP failed to manage the choledocholithiasis. CBD exploration with choledocholithotomy and T-tube drainage and cholecystectomy was done. The postoperative period was uneventful, and the T-tube was removed on the 10th day after a normal T-tube cholangiogram. CASE 2 32 year old female admitted in emergency with complain of acute pain in abdomen since 2 days. Ultrasound shows contracted gallbladder withstone along with focal collection in perihepatic and peri gallbladder region extending into subcutaneous plane with cbd stone.. Ultrasound guided pigtail catheter drainage of the collection was done. After 5 days she underwent ERCP by which cbd stones were cleared. Elective laparoscopic cholecystectomy was done. CONCLUSION A high index of clinical suspicion is necessary for prompt recognition and its proper management. Percutaneous treatment should be considered as the first-line option for patients with spontaneous biloma. In cases of persistent bile leaks, endoscopic biliary drainage and endoscopic sphincterotomy with or without stent placement should be performed. Surgery is now performed only in cases with a persistent bile leak or for treatment of an underlying disease.

The septum transversum mesenchyme induces gall bladder development

SummaryThe liver, gall bladder, and ventral pancreas are formed from the posterior region of the ventral foregut. After hepatic induction, Sox17+/Pdx1+ pancreatobiliary common progenitor cells differentiate into Sox17+/Pdx1− gall bladder progenitors and Sox17−/Pdx1+ ventral pancreatic progenitors, but the cell-extrinsic signals that regulate this differentiation process are unknown. This study shows that the septum transversum mesenchyme (STM) grows in the posterior direction after E8.5, becoming adjacent to the presumptive gall bladder region, to induce gall bladder development. In this induction process, STM-derived BMP4 induces differentiation from common progenitor cells adjacent to the STM into gall bladder progenitor cells, by maintaining Sox17 expression and suppressing Pdx1 expression. Furthermore, the STM suppresses ectopic activation of the liver program in the posterior region of the ventral foregut following hepatic induction through an Fgf10/Fgfr2b/Sox9 signaling pathway. Thus, the STM plays pivotal roles in gall bladder development by both inductive and suppressive effects.

An Adolescent Girl With Belly Pain

A 15 year old previously healthy girl presented with 3 months of right upper quadrant abdominal pain, persistent nausea, and seven kg weight loss. Her exam revealed right upper quadrant and epigastric tenderness. Laboratory investigations, including bilirubin and liver enzymes, were normal. An abdominal ultrasound revealed a contracted gallbladder and a small ovoid structure in the right upper quadrant suggesting a possible choledochal cyst. Magnetic resonance cholangiopancreatography (MRCP) better defined these lesions as a 2.8 × 2 × 2 cm “ovoid” cystic structure (small arrow in Figure 1) and a gallbladder (larger arrow Figure 1). Onendoscopic retrograde cholangiopancreatography (ERCP) both structures filled with contrast with two completely separate cystic ducts attached to the common duct (Figure 2 and online-only images available at http://links.lww.com/MPG/A94). Figure 1 Magnetic resonance cholangiopancreatography (MRCP) noted a 2.8 × 2 × 2 cm “ovoid” cystic structure (small arrow) and gallbladder (large arrow). Figure 2 ERCP shows two completely separate cystic ducts (white arrows) attached to the common bile duct as well as two distinct gallbladders. She continued to be symptomatic and subsequently had a laparoscopic cholecystectomy. The intraoperative cholangiogram confirmed the ERCP findings. Accordingly, both gallbladders were removed. Examination of the resected specimens by histology confirmed two gallbladders and entirely separate cystic ducts (see online-only images). Duplicated gallbladder is a rare anomaly of the biliary system with the reported incidence between 1 in 3800.1 The differential diagnosis for a cystic structure in the gallbladder region includes choledochal cyst, folded gallbladder, gallbladder diverticulum, focal adenomyomatosis, fibrous or vascular band and duplication of any other structure in the biliary system2. Although both ultrasound and MRCP are utilized in the evaluation of gallbladder anomalies, ERCP remains the gold standard to define this biliary tree abnormalitity3. Causey et al. recently published a similar case and contend that defining the type of gallbladder duplication (based on the Harlaftis classification4 of multiple gallbladders) will aid in the selection of operative technique5. They reason that laparoscopy can be used for type 1 (the split primordial group, sharing a single cystic duct) and a traditional open approach should be used for type 2 (accessory gallbladder arising from separate primordium with two discrete ducts)5. The consensus from multiple case reports has been to only operate on symptomatic patients and remove both gallbladders given the risk of continued symptoms and non-functionality of either structure.

Carcinosarcome de la vessie : étude anatomoclinique de 11 observations

A forty-one year old, markedly jaundiced, obese, white female was admitted to the hospital with persistent nausea and vomiting, low grade fever and no pain. A diagnosis of infectious hepatitis was made and the patient improved under intensive therapy. Ascites and an abdominal mass were then noted. Exploratory laparotomy was performed and a large mass in the gallbladder region removed, only to uncover further extensive massing. The patient expired one day after operation. The pathologist reported leiomyosarcoma of the gallbladder and cholelithiasis. This case was very similar to many reported in the literature: occurring in a female, having cholelithiasis with the sarcoma, being advanced when met clinically and being pathologically classed as spindle cell sarcoma, which far outnumbers other sarcomas of the gallbladder. It is interesting to note, however, that the patient retained her weight, had no gastrointestinal upsets prior to her present illness and had entered the hospital as a febrile, vomiting, Jaundiced patient who might very readily be considered as having infectious hepatitis.

Fetal Cholelithiasis

The fetal gallbladder can be visualized on most sonographic screening examinations. After obtaining the abdominal circumference images, angling the transducer caudal along the anterior abdominal wall to the level of the umbilical cord insertion will generally bring the gallbladder into view to the right of the umbilical vein. Fetal cholelithiasis and/or sludge in the gallbladder is an uncommon sonographic finding characterized by echogenic material that may or may not produce shadowing. The likelihood of this occurrence is most prevalent in the third trimester of pregnancy. In most cases, fetal gallstones/sludge undergo spontaneous resolution within weeks or months after birth. Most investigators believe that the presence of fetal cholelithiasis or sludge does not alter fetal prognosis or obstetrical management. The finding of an echogenic mass in the abdominal region of the fetal gallbladder should prompt the sonographer to consider sludge and/or gallstones, albeit uncommon, as a possible explanation.

Percutaneous the Diagnostic Value of Spiral CT in Gallbladder Carcinoma(40 cases report)

目的 探讨螺旋CT扫描对胆囊癌的诊断价值.方法对上腹部行螺旋CT扫描、胆囊区薄层扫描及胆囊MPR(多平面重建)重建,分析胆囊癌CT表现.结果本文40例胆囊癌的诊断与手术病理或细胞学都符合,病例类型以腺癌最为常见,占70%.结论CT扫描对胆囊癌的诊断较容易,但对壁厚型胆囊癌有一定的局限性,且早期胆囊癌诊断率不高,须结合临床表现及CT表现来进行胆囊癌与胆囊炎,胆囊癌与肝癌的鉴别诊断。

Studies on the hepatic three-dimensional reconstruction and virtual surgery using the hepatic images of the digitized virtual Chinese human female number 1 database

To study digitized virtual hepatic three-dimensional reconstruction and virtual hepatic surgery. The whole series of hepatic images taken from the database of digitized Virtual Chinese Human Female Number 1 (VCH-F1) was employed to reconstruct a three-dimensional (3D) liver. First, studied some algorithms for registration of human liver tissue images, and then, segmented the regions of liver, vein, bile duct, and gallbladder from the images. Based on them, the 3D visualization human liver model was reconstructed. Finally, a 3D visualization demo system of liver was developed based on personal computer and Windows operation system. This demo system of liver provided a graphics user interface to rotate, scale the 3D liver to observe the 3D hepatic structure, and a virtual liver simulation system of resection with primary function. The study may be beneficial to the future research on digitized virtual hepatic and virtual hepatic surgery, and the 3D visualization demo system of liver may be beneficial to the research on the hepatic structure.

Differential diagnosis of gallbladder cancer using positron emission tomography with fluorine-18-labeled fluoro-deoxyglucose (FDG-PET).

The purpose of this paper is to evaluate the utility of positron emission tomography (PET) with fluorine-18-labeled fluoro-deoxyglucose (FDG) in the preoperative differential diagnosis of gallbladder tumors. We performed PET studies of gallbladder tumors in order to predict the malignancy of these tumors preoperatively. Sixteen patients who had protuberant lesions in the gallbladder and who were scheduled to undergo surgery were studied with PET using FDG. Focally increased FDG uptake in the gallbladder region was considered malignant. The FDG-PET findings were compared with the histological findings of surgical pathology. Sensitivity of FDG-PET was 75% (6/8 patients). One of two false-negative cases suffered from diabetes mellitus, and in the other case, the lesion was small. Specificity was 87.5% (7/8 patients). A case with xanthogranulomatous cholecystitis (XGC) was the only false-positive case. FDG-PET may be able to provide important information for evaluating the malignancy of gallbladder tumors.