# Endoscopic findings of gallbladder lesions evaluated with image‐enhanced endoscopy: A preliminary study using resected gallbladders

## TL;DR

This study uses image-enhanced endoscopy to better understand and classify gallbladder lesions, aiming to improve diagnosis and biopsy accuracy.

## Contribution

The study introduces a preliminary classification of gallbladder lesions using endoscopic imaging features for improved diagnosis.

## Key findings

- Advanced gallbladder carcinoma showed distinct endoscopic features like papillary surfaces and neovascularization.
- Endoscopic imaging can differentiate between benign and malignant gallbladder lesions based on surface and vascular structures.
- The method may support targeted biopsies and innovative imaging diagnosis for gallbladder lesions.

## Abstract

The diagnosis of gallbladder (GB) lesions relies on imaging findings. Transpapillary cholangioscopy can potentially be used to diagnose GB lesions; however, the images obtained remain unclear. This study aimed to characterize the endoscopic findings of GB lesions. We examined the endoscopic features of GB lesions in 50 consecutive patients who underwent cholecystectomy. GB specimens were obtained immediately following cholecystectomy, opened on the side opposite the liver bed, and flushed with saline solution. Each lesion was assessed using a high‐resolution endoscope equipped with white light and narrow‐band imaging magnification. For elevated lesions, both the surface structure (classified as regular, irregular, or absent) and vascular structure (dilation, meandering, caliber change, non‐uniformity, and loose vessel areas) were assessed. Twelve of the 50 patients had elevated lesions, including cholesterol polyp (n = 4), hyperplastic polyp (n = 1), xanthogranulomatous cholecystitis (n = 1), and GB carcinoma (n = 6). Advanced GB carcinoma, as opposed to T1 GB carcinoma, demonstrated a papillary surface with destructive areas and neovascularization on narrow‐band imaging magnification. Endoscopic images of each GB lesion were characterized, and the differences between GB carcinomas and benign lesions were identified. This preliminary classification may contribute to innovative imaging diagnosis and targeted biopsy for diagnosing GB lesions under direct vision.