ASSESSMENT OF DIAGNOSTIC ACCURACY OF ENDOSCOPIC ULTRASOUND IN GALLBLADDER LESIONS

Aims Endoscopic ultrasound (EUS) has been widely used in the diagnosis of gallbladder lesions. The purpose of this study was to determine whether there was a difference in diagnosis rate according to gallbladder lesions.

Methods 82 patients who underwent laparoscopic cholecystectomy after EUS at our institution were included. The pathologic diagnosis and EUS were compared. Pathological diagnosis was classified by score (score 1, benign polyp; score 2, chronic cholecystitis; score 3, adenomyomatosis; score 4, adenoma; score 5, carcinoma). EUS was classified as pathological diagnosis.

Results Among 82 patients, the pathologic score 1 was 13 (15.9%), 2 was 36 (43.9%), 3 was 22 (26.8%), 4 was 3 (3.7%), and 5 was 8 (9.8%). EUS was 19 (23.2%), 5 (6.1%), 44 (53.7%), 7 (8.5%), 7 (8.5%) in order. The absolute difference between the two diagnostic scores is 0 to 4, with 0 being 38 (46.3%), 1 being 34 (41.5%), 2 or more being 10 (12.2%). Among the 0 of the absolute difference between the two diagnostic scores, diagnostic accuracy of benign polyp was 76.9% (10/13), chronic cholecystitis 11.1% (4/36), adenomyomatosis 86.4% (19/22), adenoma 33.3% (1/3), and carcinoma 57.1% (4/8). Among 2 or more of the absolute difference, 3 patients had cholesterol polyps (3/13, 23.0%), 4 patients had chronic cholecystitis (4/36, 11.1%), and 2 patients had adenomyosis (2/22, 9.0 %) and 1 carcinoma (1/8, 12.5%).

Conclusions The diagnostic accuracy of EUS for each gallbladder disease varied. The diagnostic accuracy for benign polyps, adenomyomatosis and carcinoma was high, while the accuracy for chronic cholecystitis and adenoma was low.