title: Can endoscopic ultrasound-guided fine needle aspiration offer clinical benefit for thick-walled gallbladders?
abstract: BACKGROUND
  No previous studies have compared cytology obtained under endoscopic transpapillary gallbladder drainage (ETGD) and EUS-guided fine needle aspiration (EUS-FNA) for thick-walled gallbladders.
  
  
  OBJECTIVE
  The present study investigated the diagnostic yield of bile cytology under ETGD and EUS-FNA for gallbladder tumors.
  
  
  METHODS
  A total of 69 patients were diagnosed as having gallbladder wall thickening. Among these patients, 28 patients were diagnosed by clinical follow-up, solely by imaging such as computed tomography or by histological examination of surgical specimens. The remaining 41 patients underwent ETGD and/or EUS-FNA. In these 41 patients, the clinical data collected included gender, age, diameter of gallbladder wall, site of gallbladder wall thickening, final diagnosis, adverse events, and diagnostic yield of ETGD and EUS-FNA.
  
  
  RESULTS
  Cyto-histological diagnosis with EUS-FNA was higher than that with ETGD, with a sensitivity of 100 versus 71%, specificity of 100 versus 94%, and accuracy of 100 versus 88%, respectively, in the two groups. In addition, the sampling adequacy of EUS-FNA was 100%. Adverse events were seen in five patients in the ETGD group (mild pancreatitis), although no adverse events were seen in the EUS-FNA group (P = 0.08).
  
  
  CONCLUSIONS
  Our results suggest that EUS-FNA can be safely performed for the diagnosis of gallbladder lesions. Further, this procedure may be the diagnostic method of choice over cytology of bile juice obtained via ETGD to obtain histological evidence of gallbladder cancer.
authors.affiliation: Second Department of Internal Medicine, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki-shi, Osaka, 569-8686, Japan, oguratakeshi0411@yahoo.co.jp.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Ogura
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Kurisu
authors.forename: Daisuke
authors.initials: D
authors.lastname: Masuda
authors.forename: Akira
authors.initials: A
authors.lastname: Imoto
authors.forename: Saori
authors.initials: S
authors.lastname: Onda
authors.forename: Rieko
authors.initials: R
authors.lastname: Kamiyama
authors.forename: Michihiro
authors.initials: M
authors.lastname: Hayashi
authors.forename: Malak
authors.initials: M
authors.lastname: Mohamed
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Uchiyama
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Higuchi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001646:Bile / Q000166:cytology*; D002277:Carcinoma / Q000000981:diagnostic imaging* / Q000473:pathology; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration; D005260:Female; D005706:Gallbladder Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged