Gallbladder polyps are often detected incidentally by ultrasonography. The most of gallbladder polyps are non-neoplastic such as cholesterol polyps and do not need further treatments. However, neoplastic polyps, which need additional treatments to prevent malignancy, show the same appearance on ultrasound. Clinically, the differential diagnosis between cholesterol polyps and adenomatous polyps is very important for patient follow-up and treatment. However, differential diagnosis between these two conditions is difficult using conventional trans-abdominal ultrasound. Endoscopic ultrasound (EUS) is less affected and disturbed by subcutaneous fat or intraabdominal air, so a clearer image of pancreatobiliary system can be obtained. In addition, EUS elastography and contrast enhanced EUS are recently introduced. EUS elastography enables practitioners to evaluate the stiffness of a target lesion and compare it with surrounding tissues (strain ratio). Also, contrast enhanced EUS is used widely with additional information such as presence of vessels and enhancement pattern of soft tissues. Several studies have been published that EUS elastography can help in the differential diagnosis of pancreatic solid lesions. Although studies have been conducted to confirm the usefulness of transabdomnial ultrasound with elastography or contrast enhancement at differentiating gallbladder polyps, no prospective studies have been conducted to evaluate the usefulness of EUS elastography or contrast enhanced EUS for gallbladder polyp. Therefore, with this prospective study, we would like to evaluate the diagnostic value of EUS elastography and contrast enhanced EUS for differential diagnosis of gallbladder polyps.
Study Type
OBSERVATIONAL
Enrollment
30
Seoul National University Hospital
Seoul, South Korea
RECRUITINGPathologic diagnosis of gallbladder polyp after cholecystectomy
Pathologic diagnosis of gallbladder polyps or masses in cholecystectomy specimen
Time frame: within 10 days after operation
Difference of strain ratio
Differences in strain ratio between non-neoplastic and neoplastic gallbladder polyps.
Time frame: Within two years of starting the study
Optimal cut-off valve of strain ratio
Optimal cut-off valve of strain ratio for differential diagnosis between cholesterol polyps and adenomatous polyps
Time frame: Within two years of starting the study
Diagnostic value of EUS-elastography
Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of EUS-elastography for diagnosis of cholesterol polyps.
Time frame: Within two years of starting the study
Diagnostic value of contrast enhanced EUS
Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of contrast enhanced EUS for diagnosis of cholesterol polyps.
Time frame: Within two years of starting the study
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