Gallbladder (GB) disease is classified into two broad categories: GB wall-thickening and protuberant lesions, which include various lesions, such as adenomyomatosis, cholecystitis, GB polyps, and GB carcinoma. This review summarizes recent advances in the differential diagnosis of GB lesions, focusing primarily on endoscopic ultrasound (EUS) and related technologies. Fundamental B-mode EUS and contrast-enhanced harmonic EUS (CH-EUS) have been reported to be useful for the diagnosis of GB diseases because they can evaluate the thickening of the GB wall and protuberant lesions in detail. We also outline the current status of EUS-guided fine-needle aspiration (EUS-FNA) for GB lesions, as there have been scattered reports on EUS-FNA in recent years. Furthermore, artificial intelligence (AI) technologies, ranging from machine learning to deep learning, have become popular in healthcare for disease diagnosis, drug discovery, drug development, and patient risk identification. In this review, we outline the current status of AI in the diagnosis of GB.

Objectives: Anastomotic biliary stricture (ABS) is a common complication following living donor liver transplantation (LDLT). Although plastic stents (PSs) have traditionally been the standard treatment, fully covered self‐expandable metal stents (FCSEMSs) have recently gained attention because of their potential advantages. This study aimed to retrospectively analyze cases of ABS after LDLT that were treated with intraductal FCSEMSs (ID‐FCSEMS) at our institution. Methods: This study included 46 adult patients who developed anastomotic bile duct stricture following LDLT. Twenty patients underwent ID‐FCSEMS placement, and 22 patients underwent PS placement. The FCSEMSs were scheduled for removal after 16 weeks. Results: Placement of FCSEMSs was technically successful in all 20 patients. Early complications included cholangitis in five patients, whereas late complications included one case of stent migration and one case of obstructive cholangitis. Clinical success was achieved in 16 patients. Restenosis occurred in two patients. No significant differences were found between the FCSEMS group and the PS group in terms of reimbursement points (as defined by the Japanese medical fee schedule), number of hospitalizations, and total inpatient days. Conclusions: ID‐FCSEMSs demonstrate a high success rate and favorable long‐term outcomes for ABS after LDLT. Although no significant difference in cost reduction is observed, ID‐FCSEMSs are a safe and effective therapeutic option for ABS.

A 78-year-old woman was referred to our hospital for close examination of an extramural submucosal tumor in the gastroesophageal region, suspected based on an imaging test performed for a chief complaint of epicardial pain while eating. Contrast-enhanced computed tomography revealed a 3 cm sized mass with well-defined margins and a homogeneous interior near the gastroesophageal junction. Endoscopic ultrasonography (EUS) revealed a large (28 mm) unilocular cystic lesion with a heterogeneous hypoechoic internal structure. The cyst wall was layered with a hypoechoic layer that appeared to be muscular and continuous with the external longitudinal muscle of the esophagus. Based on the EUS findings, an esophageal duplication cyst was diagnosed. Cystectomy was performed because the patient was symptomatic. Pathological examination revealed that the specimen was covered with columnar and pseudostratified ciliated epithelium without atypia and that the cyst wall comprised two layers of smooth muscle. No cartilaginous tissue was present, which is consistent with esophageal duplication cysts. Retrospectively, the EUS findings were consistent with the pathological findings.