Differentiation of gallbladder adenomyomatosis from early-stage gallbladder cancer before surgery

Jisum Moon; Yong Chan Shin; Tae-Gil Heo; Pyong Wha Choi; Jae Il Kim; Sung Won Jung; Heungman Jun; Sung Min Jung; Eunhae Um

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저자정보: Jisum Moon (Inje University College of Medicine) Yong Chan Shin (Inje University College of Medicine) Tae-Gil Heo (Inje University College of Medicine) Pyong Wha Choi (Inje University College of Medicine) Jae Il Kim (Inje University College of Medicine) Sung Won Jung (Inje University College of Medicine) Heungman Jun (Inje University College of Medicine) Sung Min Jung (Inje University College of Medicine) Eunhae Um (Inje University College of Medicine)

저널정보: 한국간담췌외과학회 Annals of Hepato-Biliary-Pancreatic Surgery 한국간담췌외과학회지 제23권 제4호

발행연도: 2019.11

수록면: 334 - 338 (5page)

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Backgrounds/Aims: This study aimed to compare the perioperative and clinical outcomes in patients undergoing laparoscopic cholecystectomy for gallbladder adenomyomatosis (GBA) or early-stage gallbladder cancer (GBC). Methods: The perioperative and clinical outcomes of 194 patients diagnosed with GBA and 30 patients diagnosed with GBC who underwent laparoscopic cholecystectomy in our institution from January 2011 to December 2017 were retrospectively compared. Results: There were no significant differences between the GBA and GBC groups in sex (male:female ratio 1.0:0.8 vs. 1.0:0.7, p=0.734), BMI (23.9±3.4 vs. 24.0±3.8 kg/㎡, p=0.916), or preoperative liver function tests. Patients in the GBC group were significantly older (50.5±14.1 vs. 65.9±10.6 years, p＜0.001) and had a higher ASA grade (40.3 vs. 63.4% grade II or III, p=0.043) than patients in the GBA group. Although there was no significant difference in preoperative diagnostic methods (p=0.442), the GBC group showed a significantly higher rate of misdiagnosis on preoperative imaging compared with postoperative histopathologic findings (30.9% vs. 53.3%, p=0.011). There were significantly more patients with gallstones in the GBA group than in the GBC group (68.6% vs. 40.0%, p=0.004). Conclusions: In older patients hospitalized for biliary colic without gallstones but with a thickened gallbladder wall with inflammation on preoperative diagnostic exam, the possibility of early-stage GBC should be considered.

#Gallbladder adenomyomatosis #Gallbladder cancer #Differential diagnosis

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