EUS of Diseases of the Gallbladder

Gallbladder diseases include various entities, such as gallstones, cholesterol polyps, adenomyomatosis, gallbladder carcinoma, and others. After transabdominal ultrasonography detects such gallbladder diseases, and computed tomography, magnetic resonance imaging, or endoscopic ultrasonography can refine the diagnosis. Among asymptomatic adults, the reported prevalence of gallbladder polyps is 4.3–6.9%. Although resection has been recommended for polypoid lesions larger than 10 mm, size alone does not reliably predict histology. Accurate diagnosis is needed to avoid unnecessary surgery, and to that endoscopic ultrasonography is important for specific diagnosis of polypoid gallbladder lesions and gallbladder wall thickening. Endoscopic ultrasonography was reported to differentiate polypoid lesions more precisely than ultrasonography (97% vs. 76% accuracy). Endoscopic ultrasonography also is useful in staging of gallbladder carcinoma. Recent advances in contrast-enhanced endoscopic ultrasonography are expected to contribute further to the diagnosis of gallbladder lesions. Additionally, endoscopic ultrasonography has shown promise in diagnosing gallbladder microlithiasis in patients with grossly clear biliary colic and normal transabdominal ultrasonographic results. In general, endoscopic ultrasonography is recommended as the second assessment of gallbladder lesions following transabdominal ultrasonography.