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PubMedDate not supplied

Double cancer of gallbladder and bile duct associated with anomalous junction of the pancreaticobiliary ductal system.

We report a case of double cancer of the gallbladder and the common bile duct associated with anomalous junction of the pancreaticobiliary ductal system, and review the literature of similar case reports. A 66-year-old woman was admitted to an associated hospital complaining of upper abdominal pain, and was diagnosed as having pancreatitis. Abdominal imaging revealed an irregularly protruding mass at the body of the gallbladder and an intraluminal protrusion at the lower third of the common bile duct. Endoscopic retrograde cholangiopancreatography also revealed anomalous junction of the pancreaticobiliary ductal system with congenital biliary dilatation of 14 mm in the largest diameter. She underwent surgical resection of the gallbladder, the extrahepatic bile duct and the gallbladder bed of the liver with a dissection of the regional lymph nodes for double cancer of the gallbladder and the bile duct associated with anomalous junction of the pancreaticobiliary ductal system. She is still alive 33 months after surgery without any signs of recurrence. There were 12 patients (including our case) reported in the literature who had double cancer of the gallbladder and the extrahepatic bile duct associated with anomalous junction of the pancreaticobiliary ductal system. Only 33% of these 12 patients had jaundice. Tumors of the 12 patients were commonly early-stage cancer both in the gallbladder (36%) and in the extrahepatic bile duct (73%). Therefore, we concluded that precise preoperative imaging of the total biliary tract should be required in order to detect early-stage cancer in patients with anomalous junction of the pancreaticobiliary ductal system before planning surgical procedures, and consideration should be given to the possibility of multiple occurrences of biliary tract cancers.

Adenocarcinoma, Papillary↗

PubMed1992

[CT assessment of gallbladder opacification 12-24 hours after angiography].

After the injection of conventional contrast agents that are largely excreted in urine, gallbladder opacification is observed in patients with renal dysfunction. However, some reports have noted that gallbladder opacification on plain radiographs occurs frequently in patients without renal impairment after the intravenous administration of Ioxaglate, one of the new low-osmolality agents. We carried out CT examination 12-24 hours after angiography with various kinds of contrast media in 437 patients to examine the incidence of gallbladder opacification. The influence of hepatobiliary and renal function on the excretion of contrast medium is discussed. Gallbladder opacification was observed in more than 60% of the patients. This result indicates that gallbladder opacification is not a rare phenomenon, and is even common in delayed CT examinations of patients with normal renal function. The high frequency of gallbladder opacification was recognized not only in the renal dysfunction group but also in the normal liver function group. Gallbladder opacification in delayed CT examination shows that the hepatobiliary tract is important in the excretion of contrast medium.

Adolescent↗

PubMedDate not supplied

Xanthogranulomatous cholecystitis mimicking stage IV gallbladder cancer.

Patients with xanthogranulomatous cholecystitis often undergo excessive surgical resections because of difficulty in distinguishing their condition from gallbladder cancer. Herein we present a patient with xanthogranulomatous cholecystitis mimicking stage IVA gallbladder cancer who underwent a hepatopancreatoduodenectomy. The 64-year-old man was admitted to the local hospital with a chief complaint of high fever, hypochondrolgia and jaundice. One month later, he transferred to Tsukuba University Hospital with a hard palpable fixed large tumor in the right hypochondrium. Computed tomography and ultrasonography showed a tumor originating from the gallbladder extending to the adjacent liver parenchyma, as well as nodes in the hepatoduodenal ligaments approaching the head of the pancreas. Endoscopic retrograde cholangiopancreatography failed to exhibit the gallbladder despite the visualization of irregular narrowing of the common hepatic duct. Angiography demonstrated encasement of the right hepatic artery and narrowing of the right portal vein. On the other hand, the level of serum carbohydrate antigen 19-9 was within normal range. Based on those findings, a right hepatic lobectomy with pancreaticoduodenectomy was conducted under the preoperative and intraoperative diagnosis of gallbladder cancer; stage IVA. The gross findings of the surgical specimen showed an ill-defined yellowish hard mass, but microscopic examination demonstrated xanthogranulomatous cholecystitis. The presented case shows that xanthogranulomatous cholecystitis can mimic an advanced gallbladder carcinoma when the severe chronic inflammatory changes have extended to the liver hilum down to the head of the pancreas. However, the normal level of tumor markers in all clinical courses might be a reason to consider xanthogranulomatous cholecystitis instead of gallbladder cancer. Even when the correct diagnosis is made, the possibility that the adjacent organs should be resected is not remote.

Cholangiopancreatography, Endoscopic Retrograde↗

PubMedDate not supplied

Gallbladder cancer: an 'Indian' disease.

The prevalence of gallbladder cancer, the commonest biliary malignancy, shows geographical and racial variations. It is reported to be rare in India. However, the incidence of gallbladder cancer in north and central India is very high--it is the commonest gastrointestinal cancer in women. Even Indian migrants to different countries have a higher risk of having gallbladder cancer as compared to the respective native populations. The incidence of gallbladder cancer parallels the prevalence of gall stone disease; large and long-standing gall stones being associated with a higher risk of gallbladder cancer. Gall stone disease is common in north India and occurs at a younger age than in the western populations. Moreover, patients with gall stone disease present for treatment a long time after the onset of symptoms. Both these factors result in prolonged exposure of the gallbladder to stones. Besides gall stone disease, various other factors may also play a role in the causation of gallbladder cancer which is an (north) Indian disease.

Female↗

PubMed2004

Establishment and characterization of unique human gallbladder cancer cell lines.

Gallbladder cancer has a dismal prognosis. Understanding the disease at the biological, genetic, molecular, cellular, and clinical level is essential for effective diagnostics and therapeutics. However, the currently established gallbladder cell lines are insufficient for better understanding and further research. The aim of our present study was to establish and characterize human gallbladder cancer cell lines. We established 5 cell lines from resected specimens of gallbladder cancers. These cell lines revealed typical tumor histopathological characteristics. We examined growth characteristics and the colony-forming ability of established cell lines in terms of their cell cycle parameters, expression of tumor markers (carcinoembryonic antigen; CEA, carbohydrated antigen 19-9; CA19-9, MUC-1 and c-kit) and the oncogene c-erbB2 by flow cytometer. Comparative genomic hybridization (CGH) analysis with specific gene probes was performed to detect changes in the gene copy numbers. Human origin of cell lines was confirmed by chromosomal analysis. Cells maintained differentiation characteristics of the original tumors. The doubling time of different cell lines varied from 30 to 96 h. All 5 cell lines formed colonies in the colony forming assays and expressed CEA, CA19-9, MUC-1 and the oncogene c-erbB2 and showed chromosomal aneuploidy. CGH analysis demonstrated gain of chromosomal region bearing SRC, RAB1, and PAP in all cell lines and hTERT in 4 cell lines. These newly established cell lines might serve as a useful model for studying the molecular pathogenesis of gallbladder cancer. Furthermore, they may serve as a model for testing new therapeutics against gallbladder cancer. These chromosomal aberrations and imbalances provide a starting point for molecular analyses of genomic regions and genes in gallbladder carcinogenesis.

Animals↗

PubMedDate not supplied

Left-sided gallbladder associated with congenital hypoplasia of the left lobe of the liver: a case report and review of literature.

Left-sided gallbladder is a rare anomaly that is often associated with other abnormal anatomy in the hepatobiliary system. We report our experience of a case of left-sided gallbladder associated with the congenital hypoplasia of the left lobe of the liver. A 71-year-old woman underwent cholecystectomy for acute cholecystitis. Intraoperative findings revealed the absence of the left lobe of the liver. The gallbladder was located in the left side of the round ligament, which was associated with abnormal intrahepatic portal branching. The incidence of left-sided gallbladder without situs inversus is very rare. The following anomalous anatomy associated with left-sided gallbladder should be a concern when a surgeon encounters a left-sided gallbladder: right-sided round ligament associated with abnormal intrahepatic portal branching and ectopic gallbladder attached to the left lobe of the liver that connects to the left hepatic duct via the cystic duct or the accessory bile duct.

Abnormalities, Multiple↗

PubMedDate not supplied

Ovine model for clear-cut study on the role of cholecystokinin in antral, small intestinal and gallbladder motility.

Cholecystokinin (CCK) is one of the major gastrointestinal hormones involved in the control of digestive tract and gallbladder motility. Its action involves several mechanisms. The ovine model was developed in order to further explore the role of CCK in gastric, small intestinal and gallbladder motility under various experimental conditions. Five Merino sheep were used with bipolar electrodes implanted to their antrum, entire small intestine and gallbladder as well as strain gauge force transducers were attached to the duodenum and gallbladder fundus, near the electrodes. In the course of chronic experiments, the myoelectric and motor activity were recorded by means of the adapted electroencephalograph. Among the variety of CCK-octapeptide or cerulein doses, three doses of each CCK peptide were selected and then applied for various time periods. Finally, the effects of the hormones administered within 30 s during phase 2 of the same or different migrating myoelectric complexes (MMCs) on gastrointestinal and gallbladder myoelectric and motor activity were studied in fasted and non-fasted animals. Injection of the highest dose inhibited rumination in four of the five sheep and inhibited phase 3 MMC in the antroduodenal region. Hormone administration inhibited dose-dependently antral myoelectric activity. The effects of moderate dose of both CCK peptides on myoelectric activity of the duodeno-jejunum was usually opposite (i.e. stimulatory) than that of the ileum. Gallbladder response to CCK peptides exhibited mostly the tonic character, and in some experiments, the slow wave frequency and amplitude were altered. It is concluded that CCK acts on several targets and different mechanisms underlie its multiple actions on gastrointestinal and gallbladder motility in sheep.

Action Potentials↗

PubMedDate not supplied

Role of preoperative helical CT before laparoscopic cholecystectomy: evaluation of gallbladder and peritoneal adhesion.

OBJECTIVE: The purpose of this study was to assess the value of preoperative helical CT for the detection of adhesion of the gallbladder or surrounding peritoneum. SUBJECTS AND METHODS: Dynamic-enhanced helical CT of the abdomen was obtained before laparoscopic cholecystectomy in 47 patients. Images were reconstructed with a 5-mm interval. Appearances on CT images were correlated with operative findings, and useful findings for predicting gallbladder or peritoneal adhesion were determined by univariate and multivariate analysis. RESULTS: Patients with gallbladder or peritoneal adhesion often have gallbladder wall thickening, gallbladder wall enhancement, and increased density of the pericholecystic fat more frequently than patients without adhesion on both precontrast and postcontrast CT. Each of these findings was significant on univariate analysis. On multivariate analysis, increased density of the pericholecystic fat and focal attenuation increase in the liver were significant factors for predicting gallbladder or peritoneal adhesion. CONCLUSION: Increased density or stranding of pericholecystic fat and transient focal hepatic attenuation increase at dynamic arterial-phase CT indicates gallbladder and peritoneal adhesion.

Cholecystectomy, Laparoscopic↗

PubMed2004

Expression of tumor necrosis factor and its receptor in gallstone and gallbladder carcinoma tissue.

BACKGROUND: Some reports have confirmed that occurrence and development of tumor are related with lots of oncogene, anti-oncogene and cytokine. This study was to detect the expression of TNFmRNA, tumor necrosis factor (TNF) and TNF receptor (TNFR) in the gallbladder mucosa which developed from hyperplasia, dysplasia to carcinoma, and to further discuss the pathogenecity of gallbladder carcinoma. METHODS: The expression of TNFmRNA, TNF and TNFR was detected by in situ hybridization and immunohistochemistry on the surgical specimens of hyperplasia, dysplasia and carcinoma of the gallbladder. RESULTS: The percentage of positive cells expressed TNFmRNA in the gallbladder mucosa was 0%, 20%, and 90%, respectively in hyperplasia, dysplasia and carcinoma (P<0.05). The percentage of positive mononuclear cells (MNCs) expressed TNFmRNA in hyperplasia, dysplasia and carcinoma of gallbladder tissues was 15%, 85%, and 90%, respectively (P<0.05). The number of positive MNC high-power field (Hpf) was 4.85+/-1.50, 6.00+/-2.71, and 9.33+/-3.07, respectively (P<0.05). The number of carcinoma cells and MNCs expressed by TNFmRNA per high-power field was increased with the increase of tumor stage. The number of carcinoma cells/Hpf in stages I-III and IV-V was 9.13+/-4.39 and 7.13+/-2.53 (P<0.05), and that of MNC/Hpf was 14.80+/-4.02 and 11.10+/-2.23 (P<0.01). The number of carcinoma cells and MNCs expressed by TNFmRNA per Hpf was increased with the increase of tumor size. In tumors of more than 2 cm or less than 2 cm in diameter, the number of positive carcinoma cells/Hpf was 14.00+/-4.20 and 8.83+/-4.96, respectively (P<0.05), but that of MNC/Hpf was 10.50+/-2.54 and 7.00+/-2.83 (P<0.05). The pattern of TNF protein expression was similar to that of TNFmRNA, whereas TNF protein expression was more frequent and extensive than TNFmRNA expression. TNFR was expressed in endothelial cells and MNCs of carcinoma, and was negative in mucosal epithelial cells and tumor cells. A positive linear correlation in TNFmRNA expression was observed between tumor cells and MNCs (r=0.687, P<0.01), a correlation in TNFmRNA and TNF protein expression of tumor cells (r=0.847, P<0.001), and a correlation in TNFmRNA and TNF protein expression of MNC in tumor tissue (r=0.643, P<0.01). CONCLUSIONS: TNFmRNA and TNF protein expression is increased during the development of gallbladder mucosa from hyperplasia, dysplasia to carcinoma, and is increased with tumor stage. This finding suggests that TNF is involved in the pathogenesis of gallbladder carcinoma induced by gallstones and the TNF expression in cancer cells may serve as a marker for tumor stage.

Biomarkers, Tumor↗

PubMed1992

Carcinoid tumor of the gallbladder: laparoscopic resection and review of the literature.

A 75-year-old woman with mild elevation of liver function test results was found to have an asymptomatic mass localized to the gallbladder by computed tomographic scan and ultrasonography. Endoscopic retrograde cholangiopancreatography revealed a fixed 2 x 4 cm filling defect in the gallbladder wall, consistent with a gallbladder neoplasm. The gallbladder and intramural neoplasm were excised successfully by use of uncomplicated laparoscopic cholecystectomy. Pathologic analysis revealed a carcinoid tumor of the gallbladder. All previously reported gallbladder carcinoid tumors in the Western literature are reviewed. Laparoscopic cholecystectomy has potential for application for the treatment of selected gallbladder neoplasms, with special preoperative assessment and intraoperative considerations being important.

Aged↗

PubMed2005

[Analysis of the treatment of unexpected gallbladder cancer].

OBJECTIVE: To investigate the secondary operation methods and the effects on the prognosis of unexpected gallbladder cancer (UGC). METHODS: A retrospective analysis on the clinical data was made for 41 patients who underwent extended radical excision from June 1995 to December 2002. Among the patients, 12 were male, 29 were female. The average age was 51 years old. The 41 patients had undergone gallbladder excision because of cholecystitis complicated lithiasis of gallbladder (32 cases), polypi of gallbladder or adenoma (9 cases). Postoperative pathology showed that 32 cases were adenocarcinoma of gallbladder, 6 cases were squamous carcinoma, 3 cases were squamous adenocarcinoma. Six cases were on the stage of Nevin I, 16 on Nevin II, 17 on Nevin III, 2 on Nevin IV. The second operation was performed after 6-30 d of the first operation. The second operation chose the improved method of Glenn excision of carcinoma of gallbladder. RESULTS: On the second operation, 14 cases were with lymphatic metastasis, 14 with gallbladder metastasis, 6 with bile duct metastasis, 2 with pancreas metastasis. Fourteen cases were on the stage of Nevin IV, 9 on Nevin V, none on Nevin I, II and III. After the second operation, 1 year survival rate was 100% (41 cases); The three-year survival rate was 53.8% (22 cases); The five-year survival rate was 17.5% (7 cases). CONCLUSION: Extended radical excision is one of the most important methods for the treatment of UGC.

Adult↗

PubMedDate not supplied

Heterotopic gastric mucosa in the gallbladder: case report and literature review.

INTRODUCTION: we report on a case of heterotopic gastric mucosa in the neck of the gallbladder and we also review 95 other reports of HGM in the gallbladder in the international medical literature from 1977. AIM: to evaluate the gold standard treatment in heterotopic gastric mucosa of the gallbladder by the analysis of literature, compared with our anecdotal experience. PATIENT AND METHOD: a 43-year-old man, who was recently symptomatic, visited our hospital to submit to laparoscopic cholecistectomy for cholelithiasis. Ultrasonography revealed a broad-based polypoid lesion in the gallbladder (2.5 cm in diameter in the neck of the gallbladder), with multiple gallstones. RESULTS: standard laparoscopic cholecystectomy was performed. The specimen revealed a 2.5 x 1.7 x 0.5 cm polypoid lesion with deep in the body, with many gallstones in the gallbladder. Histologically, the polypoid lesion consisted of gastric fundic glands located only in the mucosa of the gallbladder. The surrounding mucosa consisted of almost normal epithelium without any metaplastic changes. Postoperative technetium 99m-pertechnetate scintigraphy demonstrated no evidence of gastric heterotopia elsewhere in the body. Actually the patient is in long-time follow-up, asymptomatic. CONCLUSIONS: for its extreme difficult to make a conclusive diagnosis and thereby rule out the possibility of cancer, it appears that laparoscopic cholecystectomy may be unavoidable for patients affected by heterotopic gastric mucosa at the present time and care must be taken when a diagnosis is made based on intraoperative frozen sections.

Adult↗

PubMedDate not supplied

Thymidylate synthase and dihydropyrimidine dehydrogenase expressions in gallbladder cancer.

BACKGROUND: Although 5-Fluorouracil (5-FU) is widely used in chemotherapeutic treatment for gallbladder cancer, there is little evidence of its effectiveness. Thymidylate synthase (TS) and dihydropyrimidine dehydrogenase (DPD) are the major determinants of individual sensitivity to 5-FU, and the impact of TS and DPD expression on prognosis and 5-FU efficacy has been studied in gastrointestinal carcinomas. MATERIALS AND METHODS: TS and DPD enzymatic activities in frozen samples of 7 gallbladder cancer tissues and immunohistochemical TS and DPD protein expressions in 53 resected gallbladder cancers were evaluated. RESULTS: The DPD activity of gallbladder cancers was significantly higher than that of gastric and colon cancers (p=0.041). TS and DPD protein expressions increased in pT2 and pT3 cases compared to those in pT1 cases, and cases both with high TS and DPD expressions had a worse prognosis than both low TS and DPD expressions. However, TS and DPD expressions were not independent prognostic factors. CONCLUSION: TS and DPD protein expressions in gallbladder cancers were frequently high in pT2 and pT3 gallbladder cancers and control of high TS or DPD levels may be important for advanced gallbladder cancer therapy.

Aged↗

PubMed1991

Long-term follow-up of patients with gallbladder in situ after endoscopic sphincterotomy for choledocholithiasis.

Endoscopic sphincterotomy (EST) was performed on 148 patients with common bile duct stones and intact gallbladder. The duct was cleared in 130 cases (88%). Immediate complications occurred in 23 patients (15.5%), six of whom died. In 118 of the 139 patients discharged from the hospital, the bile ducts were cleared and the gallbladder in situ. The median observation time in these 118 cases was 42 (1-97) months, during which 13 (11%) were cholecystectomized because of symptoms or acute complications due to remaining gallbladder stones, and 49 (42%) died 2-87 (median 24) months after EST. The probability (life-table) of remaining free from cholecystectomy-requiring symptoms or complications was 0.87 after 42 months. There was no association between nonfilling of the gallbladder at ERC and subsequent problems with gallbladder stones. EST for choledocholithiasis with retained gallbladder is justified for elderly and frail patients. Indefinite postponement of cholecystectomy may be warrantable, restricting surgery to patients with symptoms from gallbladder stones. This most frequently means within 2 years after EST.

Acute Disease↗

PubMed2006

[Analysis of prognostic factors after curative resection for gallbladder carcinoma].

BACKGROUND/AIMS: Despite the development in diagnostic tools, gallbladder carcinoma is often diagnosed at an advanced stage. Therefore, early diagnosis and radical resection are most important factors for the prognosis of gallbladder carcinoma. However, prognostic factors after radical resection of gallbladder carcinoma have not been well identified. The aim of this study was to evaluate the prognostic factors of gallbladder carcinoma after curative resection. METHODS: We reviewed the records of the 115 patients with gallbladder carcinoma who underwent curative surgery between 1989 and 2004 at Yonsei University Medical Center (YUMC). The relationship between survival and clinicopathological variables was assessed. RESULTS: In 311 patients presenting with gallbladder carcinoma, 195 patients (62.5%) were radically resected. Among 195 patients, 80 patients were excluded because of incomplete clinicopathologic data and unsatisfactory follow-up. The 5 year overall survival rate was 36.0%, and disease free 5 year survival rate was 3.9%. Univariate analysis showed that survival was closely related to gross morphology, depth of tumor invasion, lymph node metastasis and preoperative serum CA19-9 level. Three significant factors identified by multivariate analysis were depth of tumor invasion, gross morphology, and preoperative serum CA19-9 level. CONCLUSIONS: Depth of tumor invasion, gross morphology, and preoperative serum CA19-9 level are independent significant prognostic factors of resectable gallbladder carcinoma.

Aged↗

PubMed2006

[Establishment of liver metastasis model of human gallbladder cancer and isolation of the subpopulation with high metastatic potential].

OBJECTIVE: To establish an experimental liver metastatic model of gallbladder cancer and isolate the subpopulation with high metastatic potential from the model, which may serve as a reliable tool in research on liver metastasis of gallbladder cancer in vivo and in vitro. METHODS: Human gallbladder cancer cells of the line GBC-SD were cultured. Ten nude athymic BALB/c mice, aged 4 approximately 5 weeks, underwent inoculation of suspension of GBC-SD cells into the spleens and then their spleens were resected. Three weeks later laparotomy was performed to observe if liver metastasis occurred. Once liver metastasis was discovered, the mice were killed and the livers were taken out to undergo microscopy, tumor cells were isolated from the metastatic foci and cultured in vitro, and then inoculated into other 10 mice in the same way as their parents cells for the second round of selection. The similar steps were repeated, altogether for three rounds of selection and a total 30 mice were inoculated in 3 rounds so as to find subpopulation with high metastatic potential. Another 10 mice underwent subcutaneous inoculation, 90 days later the mice were killed to observe if pulmonary metastasis occurred. PCR was used to detect the 3 microsatellite sequences D14S68, D18S69, and D20S199 in the DNA samples of the gallbladder cancer cells of the parent cell line GBC-SD, the isolated cells of the subpopulation with high metastatic potential, and the liver of experimental animal. RESULTS: 90% of the mice inoculated subcutaneously with the GBC-SD cells developed subcutaneous tumors, however, no mouse in this group died and no pulmonary metastasis was found. The liver metastatic rate was 65% in the 10 mice undergoing intrasplenic inoculation. Thus a metastatic model of human gallbladder cancer in nude mice was established. The liver metastatic tumors were uniformly distributed throughout the liver parenchyma with predominance to the periphery. Despite multiple sites of involvement, the left lobes were most commonly affected in all experimental animals. Histological examination of the metastatic lesion demonstrated adenocarcinoma. Gross hepatic metastasis was detected 10, 7, and 5 weeks after the inoculation respectively in the first, second, and third round selection respectively with an incidence rate of metastases of 60%, 70%, and 90% respectively. From the third round metastatic model a subpopulation with high metastatic potential was isolated and designated as GBC-SD/M, which exhibited the similar histological characteristics as its parent cell line GBC-SD under inverted light microscopy. The three amplified bands at the sites 14S68, D18S69, and D20S199, amplified with the three pairs of specific primers for the three homo-specific microsatellites, were detected in the GBC-SD cells and GBC-SD/M cells, but not in the liver of tumor-bearing animal. CONCLUSION: A liver metastasis model of human gallbladder cancer has been established, a reliable and efficient tool for study on the metastasis of gallbladder cancer to liver in vivo. Isolated from hepatic metastasis, the line of GBC-SD/M is a subpopulation with high metastatic potential, retaining the histological properties and identification of genetic background of its parent cell line GBC-SD.

Animals↗

PubMedDate not supplied

Ultrasonographic evaluation of gallbladder volume and contractility in diabetic patients of different ages.

Gallbladder volume and contractility were measured, by means of real-time ultrasonography, in 48 insulin treated diabetic patients free from autonomic neuropathy, and in 91 healthy control subjects. All controls and diabetic patients were on a isocaloric and balanced diet. Gallbladder measurements were taken after an overnight fast and again 60-75 minutes after each meal. Gallbladder volume was at all times significantly greater in diabetic patients than in controls, while gallbladder contractility was similar. In diabetic patients, but not in controls, gallbladder volume was greater in the elderly than in adults, with no relationship between gallbladder volume and duration of diabetes. It is concluded that enlargement of the gallbladder might be a risk factor for gallstones in diabetic patients.

Adult↗

PubMed1991

Adenomyomatosis of the gallbladder. A premalignant lesion?

Gallbladder cancer is the most common malignant tumor of the biliary tract, but its early diagnosis is uncommon. The use of ultrasonography has increased the detection of benign gallbladder tumors, and the premalignant potential of gallbladder adenomas is now undisputed. Adenomyomatosis of the gallbladder has recently been suggested to have malignant potential, and we report a case of adenocarcinoma of the gallbladder occurring in localized adenomyomatosis that was successfully treated by radical curative surgery. The more rigorous use of ultrasonography and a more aggressive approach to "benign" polypoid lesions of the gallbladder may represent the best way of achieving early diagnosis and cure in gallbladder cancer.

Adenocarcinoma↗