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{{Gallbladder cancer}}
{{Gallbladder cancer}}
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{{CMG}}; {{AE}}{{VKG}}
==Overview==
==Overview==
According to the National Comprehensive Cancer Network (NCCN) guidelines, gallbladder cancer may be diagnosed as an accidental finding in patients who undergo [[laparoscopic]] [[cholecystectomy]].
According to the National Comprehensive Cancer Network (NCCN) guidelines, [[gallbladder cancer]] may be diagnosed as an incidental finding in patients who undergo [[laparoscopic]] [[cholecystectomy]].
 
==Screening==
==Screening==
* According to the NCCN guidelines, [[screening]] for gallbladder cancer patients is recommended  with [[Endoscopy|endoscopic]] ultrasongraphy (EUS), [[computed tomography]] (CT) , [[magnetic resonance imaging]] (MRI) with/without contrast and patients after incidental finding during [[laparoscopic]] [[cholecystectomy]] patient are recommmends considering staging [[laparoscopy]].<sup> </sup>
* According to the NCCN guidelines, [[screening]] for [[gallbladder cancer]] patients include followings:
 
**[[Endoscopic ultrasound|Endoscopic]] ultrasonography (EUS)
=== Ultrasound ===
**[[Computed tomography]] ([[Computed tomography|CT]]) 
* when [[gallbladder]] pathology is suspected [[ultrasonography]] is most commonly the first choice for screening.
**[[Magnetic resonance imaging]] ([[MRI]]) with/without contrast
*Patients after incidental finding during [[laparoscopic]] [[cholecystectomy]] patient are recommends considering staging [[laparoscopy]].<sup> </sup>
* When [[gallbladder]] pathology is suspected [[ultrasonography]] is most commonly the first choice for [[Screening (medicine)|screening]].
* [[Sensitivity]] and [[specificity]] of [[ultrasound]] screening is 85% and 80%.
* [[Sensitivity]] and [[specificity]] of [[ultrasound]] screening is 85% and 80%.
* A High-resolution contrast-enhanced ultrasonography identifies up to 70–90% of [[Polypoidy|polypoid]] gallbladder lesions.<ref name="pmid21628925">{{cite journal |vauthors=Inui K, Yoshino J, Miyoshi H |title=Diagnosis of gallbladder tumors |journal=Intern. Med. |volume=50 |issue=11 |pages=1133–6 |year=2011 |pmid=21628925 |doi= |url=}}</ref>
* High-resolution contrast-enhanced [[ultrasonography]] identifies up to 70–90% of [[Polypoidy|polypoid]] [[gallbladder]] lesions.<ref name="pmid21628925">{{cite journal |vauthors=Inui K, Yoshino J, Miyoshi H |title=Diagnosis of gallbladder tumors |journal=Intern. Med. |volume=50 |issue=11 |pages=1133–6 |year=2011 |pmid=21628925 |doi= |url=}}</ref>
* Gallbladder cancer on ultrasound have one of the following feartures<ref name="pmid26421012">{{cite journal |vauthors=Kanthan R, Senger JL, Ahmed S, Kanthan SC |title=Gallbladder Cancer in the 21st Century |journal=J Oncol |volume=2015 |issue= |pages=967472 |year=2015 |pmid=26421012 |pmc=4569807 |doi=10.1155/2015/967472 |url=}}</ref>
** 1) A mass in  the gallbladder
** 2) A [[polyp]] in the gallbladder
** 3) Asymmetric wall thickening of the [[gallbladder]]
*  [[Polyps]] which are over 1 cm in [[diameter]] have higher chance to contain an [[invasive]] cancer than smaller ones.<ref name="pmid7572497">{{cite journal |vauthors=Wibbenmeyer LA, Sharafuddin MJ, Wolverson MK, Heiberg EV, Wade TP, Shields JB |title=Sonographic diagnosis of unsuspected gallbladder cancer: imaging findings in comparison with benign gallbladder conditions |journal=AJR Am J Roentgenol |volume=165 |issue=5 |pages=1169–74 |year=1995 |pmid=7572497 |doi=10.2214/ajr.165.5.7572497 |url=}}</ref>
* With Contrast-enhanced ultrasonography  gallbladder cancer shows an “eruption sign”<ref name="pmid24959553">{{cite journal |vauthors=Vijayakumar A, Vijayakumar A, Patil V, Mallikarjuna MN, Shivaswamy BS |title=Early diagnosis of gallbladder carcinoma: an algorithm approach |journal=ISRN Radiol |volume=2013 |issue= |pages=239424 |year=2013 |pmid=24959553 |pmc=4045520 |doi=10.5402/2013/239424 |url=}}</ref>
 
=== '''Computer Tomography (CT)''' ===
* The most common non-invasive imaging studies for evaluating gallbladder cancer include CT.
* In diagnosis and staging of GBC CT scan is useful.
* Ct scan is helpful in detection of invasion to adjacent tissues like liver, lymphadenopathy and other organs
* Four patterns of gallbladder cancer have been described on CT scan
* In CT scan features of gallbladder cancer include<ref name="pmid22581235">{{cite journal |vauthors=Deshmukh SD, Johnson PT, Sheth S, Hruban R, Fishman EK |title=CT of gallbladder cancer and its mimics: a pattern-based approach |journal=Abdom Imaging |volume=38 |issue=3 |pages=527–36 |year=2013 |pmid=22581235 |doi=10.1007/s00261-012-9907-1 |url=}}</ref><ref name="pmid249595533">{{cite journal |vauthors=Vijayakumar A, Vijayakumar A, Patil V, Mallikarjuna MN, Shivaswamy BS |title=Early diagnosis of gallbladder carcinoma: an algorithm approach |journal=ISRN Radiol |volume=2013 |issue= |pages=239424 |year=2013 |pmid=24959553 |pmc=4045520 |doi=10.5402/2013/239424 |url=}}</ref>
** Polypoid mass within the gallbladder
** Thickening of the gallbladder wall
** A mass replacing the gallbladder 
 
=== '''Endoscopic retrograde cholangiopancreatography (ERCP)'''<ref name="pmid12235875">{{cite journal |vauthors=Kinoshita H, Hara M, Hashino K, Hashimoto M, Nishimura K, Kodama T, Hamada S, Matsuo H, Yasunaga M, Odo M, Tamae T, Noritomi T, Hiraki M, Okuda K, Imayama H, Shirouzu K, Aoyagi S |title=A case of gallbladder cancer associated with pancreaticobiliary maljunction |journal=Kurume Med J |volume=49 |issue=1-2 |pages=61–5 |year=2002 |pmid=12235875 |doi= |url=}}</ref> ===
* ERCP may be helpful in diagnosing abnormal pancreaticobiliary ducts and also in collection of biles and biospy samples
* ERCP  is a very good tool in diagnosing filling defects of the gallbladder, It is best used for identifying tumour extension into the bile ducts.


==References==
==References==

Latest revision as of 14:09, 9 January 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vamsikrishna Gunnam M.B.B.S [2]

Overview

According to the National Comprehensive Cancer Network (NCCN) guidelines, gallbladder cancer may be diagnosed as an incidental finding in patients who undergo laparoscopic cholecystectomy.

Screening

References

  1. ↑ Inui K, Yoshino J, Miyoshi H (2011). "Diagnosis of gallbladder tumors". Intern. Med. 50 (11): 1133–6. PMID 21628925.


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