Can Endoscopic Ultrasound-Guided Fine Needle Aspiration Offer Clinical Benefit for Thick-Walled Gallbladders?

Background No previous studies have compared cytology obtained under endoscopic transpapillary gallbladder drainage (ETGD) and EUS-guided fine needle aspiration (EUS-FNA) for thick-walled gallbladders. Aim The present study investigated the diagnostic yield of bile cytology under ETGD and EUS-FNA fo...

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Published in:Digestive diseases and sciences 2014-08, Vol.59 (8), p.1917-1924
Main Authors: Ogura, Takeshi, Kurisu, Yoshitaka, Masuda, Daisuke, Imoto, Akira, Onda, Saori, Kamiyama, Rieko, Hayashi, Michihiro, Mohamed, Malak, Uchiyama, Kazuhisa, Higuchi, Kazuhide
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Bile - cytology
Biochemistry
Carcinoma - diagnostic imaging
Carcinoma - pathology
Diagnosis
Endoscopic Ultrasound-Guided Fine Needle Aspiration
Female
Gallbladder cancer
Gallbladder Neoplasms - diagnostic imaging
Gallbladder Neoplasms - pathology
Gastroenterology
Hepatology
Humans
Male
Medicine
Medicine & Public Health
Middle Aged
Oncology
Original Article
Pneumoviridae
Transplant Surgery
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Summary:Background No previous studies have compared cytology obtained under endoscopic transpapillary gallbladder drainage (ETGD) and EUS-guided fine needle aspiration (EUS-FNA) for thick-walled gallbladders. Aim The present study investigated the diagnostic yield of bile cytology under ETGD and EUS-FNA for gallbladder tumors. Methods A total of 69 patients were diagnosed as having gallbladder wall thickening. Among these patients, 28 patients were diagnosed by clinical follow-up, solely by imaging such as computed tomography or by histological examination of surgical specimens. The remaining 41 patients underwent ETGD and/or EUS-FNA. In these 41 patients, the clinical data collected included gender, age, diameter of gallbladder wall, site of gallbladder wall thickening, final diagnosis, adverse events, and diagnostic yield of ETGD and EUS-FNA. Results Cyto-histological diagnosis with EUS-FNA was higher than that with ETGD, with a sensitivity of 100 versus 71 %, specificity of 100 versus 94 %, and accuracy of 100 versus 88 %, respectively, in the two groups. In addition, the sampling adequacy of EUS-FNA was 100 %. Adverse events were seen in five patients in the ETGD group (mild pancreatitis), although no adverse events were seen in the EUS-FNA group ( P  = 0.08). Conclusion Our results suggest that EUS-FNA can be safely performed for the diagnosis of gallbladder lesions. Further, this procedure may be the diagnostic method of choice over cytology of bile juice obtained via ETGD to obtain histological evidence of gallbladder cancer.
ISSN:0163-2116
1573-2568
DOI:10.1007/s10620-014-3100-z