Yukio Iwashita, Hiroki Uchida, Teijiro Hirashita, Yuichi Endo, Kazuhiro Tada, Kunihiro Saga, Hiroomi Takayama, Masayuki Ohta, Masafumi Inomata. Oita University Faculty of Medicine
Introduction: Determining tumor invasiveness before operation is one of the most important unsolved issues in the management of gallbladder cancer. We hypothesized that the assessment of irregular vessels on the gallbladder wall may be useful for detecting subserosal infiltration. We present an initial report on the clinical usefulness of laparoscopic narrow band imaging (NBI) for the intraoperative diagnosis of tumor invasiveness in gallbladder carcinoma.
Methods: Thirteen patients with gallbladder cancer were included in this study. Patients with tumors located in the liver bed and those with definitive invasion observed on computed tomography findings were excluded from this study. Gallbladders were observed using NBI and the microvasculature was evaluated. According to previous reports of endoscopic NBI, we defined four findings as positive: vessel dilatation, tortuousness, interruption, and heterogeneity. The NBI findings were compared with postoperative pathological findings. The study protocol was approved by the Institutional Review Board of the Oita University.
Results: The serosal surface of the tumor site and its microvasculature were successfully observed in all 13 patients. Laparoscopic NBI detected at least one abnormal finding in seven patients, and postoperative pathology showed subserosal infiltration accompanied by vessel invasion. On the contrary, six patients with no positive NBI findings showed mild or no subserosal infiltration and no vessel invasion.
Conclusions: Our study indicated that laparoscopic NBI may be useful for diagnosing subserosal infiltration accompanied by a vessel invasion.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 86727
Program Number: P098
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster
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