Preoperative diagnoses and identification rates of unexpected gallbladder cancer

Comparative diagnostic efficacy and safety of ultrasound-guided percutaneous transhepatic biopsy and endoscopic ultrasound-guided fine-needle aspiration biopsy for gallbladder tumors

The objective of this study was to compare the diagnostic efficacy and safety of ultrasound-guided percutaneous transhepatic gallbladder biopsy (PTGB) with endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) in the assessment of gallbladder tumors. We conducted a retrospective, single-center study involving 101 patients diagnosed with gallbladder cancer who underwent either PTGB or EUS-FNA between January 2019 and December 2022. The study cohort was divided into two groups: 52 patients underwent PTGB, and 49 underwent EUS-FNA. Clinical data, diagnostic outcomes, patient demographics, and complications were systematically documented. The sensitivity, accuracy, and incidence of complications were evaluated for both groups. The sensitivity and accuracy rates were 94.23% and 94.23% for PTGB compared to 97.82% and 97.96% for EUS-FNA, with no significant difference between the two techniques. However, EUS-FNA was associated with significantly lower rate of adverse reactions (2.04%) compared to PTGB (15.38%). Both PTGB and EUS-FNA exhibited high diagnostic efficacy for gallbladder tumors. However, EUS-FNA demonstrated a significantly lower incidence of complications, making it a compelling alternative to PTGB, especially when percutaneous biopsy is unsuccessful or not feasible. High-quality prospective, multicenter trials are recommended to further validate these findings and to refine biopsy guidelines for gallbladder tumors.

Practices in the Management of Incidental Gallbladder Cancer

Peeyush VarshneyBackground  Histopathology of gallbladder removed for stones may reveal incidental gallbladder cancer (iGBC). We conducted this online e-survey to document the knowledge and practices of management of iGBC among surgeons in India. Methods  A 38-question online e-survey Results  Two-hundred thirty responses were recorded. Ninety-eight out of two-hundred (49%) responses were general surgeons. Two-hundred ten out of two-hundred twenty-one (95%) saw at least one iGBC per year, but only 74/225 (32%) correctly defined true iGBC. One-hundred seventy-eight out of two hundred twenty-two (80%) did computed tomography/magnetic resonance imaging for thick-walled gallbladder (GB) detected on ultrasound, while 25/222 (11%) did laparoscopic cholecystectomy and 14/222 (6%) did open cholecystectomy. For GB mass on laparoscopy, 16/222 (7%) responses went ahead with simple cholecystectomy. Seventy-four out of two-hundred twenty-five (32%) responses routinely used bag while extracting GB. One-hundred ninety-one out of two-hundred twenty-five (86%) mentioned about stone/bile spill, 121/220 (55%) mentioned about use of bag for extraction while 137/220 62% mentioned port used for extraction of GB in operation notes. One-hundred sixty-six out of two-hundred twenty-seven (73%) always cut open GB after cholecystectomy. On encountering a mass/lesion on cut open GB, 111/225 (49%) sent it for frozen section, 89/225 (40%) sent for routine histopathology while 10% (22/225) directly proceeded for extended cholecystectomy. Ten out of two-hundred twenty-seven (4.4%) did not consider it important to send GB for histopathology. T stage on histopathology is most important factor for deciding reoperation by 205/223 (91%). Conclusion  There are lacunae in understanding and deficiencies in management of iGBC in India-a high GBC incidence country. The situation is likely to be worse in low GBC incidence areas. There is need for more awareness and knowledge for proper management of iGBC among surgeons.

Effect of Microscope Combined with Wechat Smart Platform on Clinical Efficacy and Gastrointestinal Function of Patients with Cholecystolithiasis Combined with Common Bile Duct Stones

To explore the clinical efficacy of microscope combined with Wechat smart platform in patients with cholecystolithiasis and choledocholithiasis, this paper proposes the effect of microscope combined with Wechat smart platform intervention after laparoscopic lithotomy and choledocholithotomy on the clinical efficacy and gastrointestinal function of patients with cholecystolithiasis combined with choledocholithiasis. From February 2018 to March 2019, 78 patients with gastric cancer were selected by our clinic and included in the research team. Evaluate the efficacy of endoscopic biliary lithotomy (LBL) + bile duct lithotomy (TBL) + T-tube drainage therapy to provide reliable evidence for improved efficacy and efficacy in order to provide a strong reference for improving the effectiveness and safety of surgical treatment of choledocholithiasis. Safety of surgical treatment of diseases. Gallstone disease. The experiments did not show any significant differences between the two groups during surgery. Diabetes was lower in the control group, and hospital incidence was lower in the control group. There were no significant differences between the two groups for preoperative WHOQOL-100 scores. Two weeks and four weeks after surgery, the man-key-100 score was higher than that of the control group. Endoscopic cholecystectomy + choledocholithotomy + choledochoscopic lithotomy + T-tube fluid have been shown to be effective in promoting rapid intestinal function and improving patient quality of life and are appropriate for therapeutic use.

Essential updates 2019/2020: Surgical treatment of gallbladder cancer

Gallbladder cancer is a biliary tract cancer that originates in the gallbladder and cystic ducts and is recognized worldwide as a refractory cancer with early involvement of the surrounding area because of its anatomical characteristics. Although the number of cases is increasing steadily worldwide, the frequency of this disease remains low, making it difficult to plan large-scale clinical studies, and there is still much discussion about the indications for surgical resection and the introduction of multidisciplinary treatment. Articles published between 2019 and 2020 were reviewed, focusing mainly on the indications for surgical resection for each tumor stage, the treatment of incidental gallbladder cancer, and current trends in minimally invasive surgery for gallbladder cancer.