Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 26, 2020; 8(24): 6358-6363
Published online Dec 26, 2020. doi: 10.12998/wjcc.v8.i24.6358
Confocal laser endomicroscopy distinguishing benign and malignant gallbladder polyps during choledochoscopic gallbladder-preserving polypectomy: A case report
Bo-Fu Tang, Tong Dang, Qiu-Hong Wang, Zhi-Heng Chang, Wei-Jie Han
Bo-Fu Tang, Tong Dang, Zhi-Heng Chang, Department of Digestive Diseases, Inner Mongolia Institute of Digestive Diseases, The Second Affiliated Hospital of Baotou Medical College, Baotou 014030, Inner Mongolia Autonomous Region, China
Qiu-Hong Wang, Wei-Jie Han, Department of Digestive Minimally Invasive Surgery, The Second Affiliated Hospital of Baotou Medical College, Baotou 014030, Inner Mongolia Autonomous Region, China
Author contributions: Tang BF performed the pCLE examination and drafted the manuscript; Dang T reviewed and revised the manuscript and approved the final manuscript as submitted; Wang QH and Han WJ completed the operation; Chang ZH participated in the design of the manuscript; All authors read and approved the final manuscript.
Informed consent statement: Written informed consent was obtained from the patient for publication of this case report and any accompanying images and videos.
Conflict-of-interest statement: The authors declare no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Tong Dang, MD, Professor, Department of Digestive Diseases, Inner Mongolia Institute of Digestive Diseases, The Second Affiliated Hospital of Baotou Medical College, No. 30 Hudemulin Rd, Qingshan District, Baotou 014030, Inner Mongolia Autonomous Region, China. dtong999@sina.com
Received: August 26, 2020
Peer-review started: August 26, 2020
First decision: September 24, 2020
Revised: September 28, 2020
Accepted: October 13, 2020
Article in press: October 13, 2020
Published online: December 26, 2020
Abstract
BACKGROUND

In the last decade, confocal laser endomicroscopy (CLE) has emerged as a new endoscopic imaging modality for real-time in vivo histological examination at the microscopic level. CLE has been shown to be useful for distinguishing benign and malignant lesions and has been widely used in many digestive diseases. In our study, we used CLE for the first time to examine the morphology of cholesterol polyps as well as the different parts of normal gallbladder mucosa.

CASE SUMMARY

A 57-year-old woman was diagnosed by ultrasound with a polyp of 21 mm in the gallbladder wall. She consented to polyp removal by laparoscopic choledo-choscopy. During laparoscopic cholecystectomy combined with choledochoscopic polyp resection, CLE was used to observe the morphology of the polyp surface cells. The appearance of the mucosa and microvessels in various parts of the gallbladder were also observed under CLE. Through comparison between postoperative pathology and intraoperative CLE diagnosis, the reliability of intraoperative CLE diagnosis was confirmed. CLE is a reliable method to examine living cell pathology during cholecystectomy. Based on our practice, CLE should be prioritized in the diagnosis of gallbladder polyps.

CONCLUSION

Compared with traditional histological examination, CLE has several advantages. We believe that CLE has great potential in this field.

Keywords: Confocal laser endomicroscopy, Laparoscopy, Choledochoscope, Gallbladder polyp, Diagnosis, Case report

Core Tip: Confocal laser endomicroscopy (CLE) has shown to be useful in distinguishing benign and malignant lesions and has been widely used in many digestive diseases, but in gallbladder disease, it has not been that popular. In our study, we used CLE for the first time to examine the morphology of cholesterol polyps as well as the different parts of normal gallbladder mucosa. Based on our practice, CLE should be prioritized in the diagnosis of gallbladder polyps. We believe that CLE has great potential in this field.