Two Cases of Gallbladder Diseases Diagnosed with Double Contrast Study of the Gallbaldder

Abstract

With the developement of the conventional abdominal ultrasound, many asymptomatic gallbladder diseases are noted. The combined diagnostic modalities using abdominal ultrasound, endoscopic ultrasound and endoscopic retrograde cholangiopanereatography are useful for the diagnosis of gallbladder diseases, especially polypoid lesions. But, diagnostic accuracy or ability is not satisfactory for the detection of early gallbladder cancer, among which there are increasing trends of flat or superficial type. Many efforts were tried to diagnose these lesions through the variable methods by direct access to the gallbladder, such as percutaneous transhepatic cholecystoscopy(PTCCS). With the advent of cystic duct cannulation method, endoscopic cholecystoduodenal stenting or nasocholecystic drainage come to be available for the treatment of acute suppurative cholecystitis. Via this route, double contrast study with barium sulfate and CO2 showed fine reticular mucosal structures of the gallbladder and increased diagnostic accuracy af the flat type cancer. We report 2 cases of gallbladder diseases with early cancer confined to the mucosa and adenomyomatous hyperplasia. They were diagnosed by the double contrast method of gallbladder that was firstly introduced domestically by us after endoscopic cannulation of cystic duct and pla~eement of the catheter to the gallbladder. (Korean J Gastrointest Endosc 16: 1029-1038, 1~996)