胆嚢隆起性病変に対する腹部超音波診断能と治療上の問題点

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  • THE DIAGNOSTIC CAPACITY OF ABDOMINAL ULTRASONOGRAPHY AND PROBLEMS IN TREATMENT FOR ELEVATED LESIONS OF THE GALLBLADDER

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Ninety-six cases with an elevated lesion of the gallbladder were analyzed to elucidate the diagnostic capacity of abdominal ultrasonography (US) and problems in the treatment for such elevated lesions of the gallbladder. Most of the nodular lesions on US were cancer, except adenomyomatosis. Moreover all eight cases with nodular type cancer more than 11mm in size invaded over the subserosal layer. These results indicate that the nodular lesions are necessary to be operated on as soon as possible once they are discovered and if a possibility of adenomyomatosis cannot be ruled out. In the papillary lesions less than 10mm in size, the frequency of cancer is 2%, versus 60% in the lesions more than 11mm in size. All papillary type cancers less than 20mm in size on US or macroscopic finding invaded the mucosal layer. These results suggest that the papillary lesions more than 11mm in size are necessary to be treated as cancer, but those less than 10mm in size can be followed until they grow to 10mm in size, even if the lesions are suspected of malignant potential. The lesions less than 10mm in size can remain in an early phase, if those are cancer.

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