| Theme | Surgical Indication for Gastrointestinal Diseases in the Era of Endoscopic Surgery | |
|---|---|---|
| Title | Elevated Lesions in the Gallbladder | |
| Publish Date | 2008/04 | |
| Author | Ichiro Hirai | Department of Gastroenterological and General Surgery, Yamagata University School of Medicine |
| Author | Toshiyuki Moriya | Department of Gastroenterological and General Surgery, Yamagata University School of Medicine |
| Author | Toshihiro Watanabe | Department of Gastroenterological and General Surgery, Yamagata University School of Medicine |
| Author | Shuichiro Sugawara | Department of Gastroenterological and General Surgery, Yamagata University School of Medicine |
| Author | Wataru Kimura | Department of Gastroenterological and General Surgery, Yamagata University School of Medicine |
| [ Summary ] | Laparoscopic cholecystectomy has become the gold standard operation for gallbladder diseases. Gallbladder cancer occurrs in approximately 1 % of patients treated with laparoscopic cholecystectomy. Port site recurrence and dissemination are serious complications. The most frequently observed elevated lesion in the gallbladder is cholesterol polyps, which display a thin steal, hyperechoic, mulberry like surfaces, and occur in multiples. Tumors with sessile, low-isoechoic, irregular surfaces and greater than 10 mm in diameter should be considered to be gallbladder cancer. Operations way also be performed for tumors which are larger. There are many diagnostic options for gallbladder tumors, such as CTs, MRIs and Doppler US. However, EUS is considered to be the most reliable diagnostic technique for diagnosis of malignancies. When advanced gallbladder cancer is revealed during or after laparoscopic cholecystectomy, partial resection of the liver and lymph node dissection should also be performed. Preoperative meticulous diagnosis, due to conditions such as wide or thin peduncles, size, surface shape and echo levels are important for treating elevated gallbladder lesions. |
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