Is ultrasound diagnosis of gallbladder cancer accurate?

The differential diagnosis of gallbladder cancer requires different treatments depending on the course of the tumor:

Early gallbladder cancer is mainly differentiated from gallbladder polypoid lesions. The diameter of gallbladder cancer is mostly greater than 1.2 cm, with a wide pedicle and thickened gallbladder wall. It is very difficult to differentiate between malignant transformation of gallbladder adenomatous polyps and benign adenomas. Gallbladder adenomas are considered precancerous lesions and should be surgically removed once diagnosed, so it does not affect surgical treatment decisions. About 57% of domestic gallbladder cancer patients have concurrent gallstones. Patients often have symptoms of biliary diseases for a long time. Such patients are most likely to be ignored, or the symptoms caused by gallbladder cancer are explained by gallstones. In differential diagnosis, it is mainly for elderly and female patients who have long-term gallstones, atrophic or full gallbladder stones, and abdominal pain symptoms that worsen and become persistent. The possibility of gallbladder cancer should be considered and in-depth examinations should be performed.

Advanced gallbladder cancer also needs to be differentiated from primary liver cancer that invades the gallbladder, forming a mass and obstruction of the gallbladder outlet. Hepatocellular carcinoma that invades the gallbladder can cause large lymph node metastases in the hilar region and hepatoduodenal ligament, similar to lymph node metastasis in advanced gallbladder cancer. Gallbladder neck cancer can directly invade or cause high-level bile duct obstruction through lymph node metastasis, and the clinical manifestations are similar to hilar cholangiocarcinoma. Sometimes the original cancerous gallbladder has been surgically removed, but a pathological diagnosis cannot be obtained for various reasons. After surgery, local tumor recurrence and hilar bile duct obstruction can make differential diagnosis difficult.