PorcelainGallbladder: Is Observation A Safe Option in Select Populations? Management of gallbladder wall calcifications has been controversial for many decades. Although the traditionally perceived strong association with gallbladder cancer mandated prophylactic cholecystectomy, newer evidence suggests a much lesser association and might indicate an observational approach. A retrospective
PorcelainGallbladder: Often an Overlooked Entity Porcelaingallbladder (GB) is a rare but potentially premalignant condition with minimal symptoms. Accident and Emergency (A&E) departments often tend to investigate abdominal pain through plain radiographs, which are occasionally reported by radiologists, thereby leaving behind few uncommon conditions, such as porcelaingallbladder unreported
PorcelainGallbladderPorcelaingallbladder or calcified gallbladder is a rare entity and is considered as the end stage of chronic cholecystitis. This disease is rarely diagnosed preoperatively and usually mimics carcinoma gallbladder. Hereby, we present a rare and interesting case of porcelaingallbladder that was diagnosed preoperatively and managed by cholecystectomy. Goel A, Agarwal A, Gupta S, Bhagat TS, Kumar G, Gupta AK. PorcelainGallbladder. Euroasian J Hepato-Gastroenterol 2017;7(2):181-182.
PorcelainGallbladder: Decoding the malignant truth Gallbladder calcification, also referred to as porcelaingallbladder, has received significant attention in the medical literature due to its perceived role in increasing the risk of developing a gallbladder carcinoma. However, recent reports raise questions challenging this purported high risk. While previous studies reported a concomitant incidence of gallbladder cancer in porcelaingallbladder ranging from 7-60%, more recent analyses indicate the incidence to be much lower (6%). Based on evidence in the current literature, a prophylactic cholecystectomy is not routinely recommended for all patients with porcelaingallbladder and should be restricted to those with conventional indications, such as young patients. However, it is important
A porcelaingallbladder and a rapid tumor dissemination Porcelaingallbladder is a very rare entity that consists of a calcification of the gallbladder wall, and is associated with carcinoma in 12.5-62% of patients, although recent studies suggest weaker association. We describe an 80-year-old woman who presented with colicky abdominal pain in the right upper quadrant, radiating to the back and associated with vomiting. Physical examination revealed jaundice, murphy's sign was negative. Hepatic-biliary tract ultrasound revealed porcelaingallbladder, she was referred to the surgical team for a scheduled cholecystectomy. A month later, she presented diffuse abdominal pain. Imaging studies showed a disseminated process affecting liver's segments, capsule, and hilum; and lungs. An aggressive
PorcelainGallbladder: A Benign Process or Concern for Malignancy? Gallbladder wall calcifications, otherwise known as porcelaingallbladder, have received considerable attention due to its perceived association with gallbladder carcinoma. While the perception of a strong correlation persists, more recent reports raise conceivable doubts. A systematic literature search was conducted of human
surgical treatment outweighs the potential risk of developing complications from the stones. * Prophylactic cholecystectomy in asymptomatic gallstone disease may be considered for people with a partially calcified 'porcelain' gallbladder. * For a person with asymptomatic gallstones found in the common bile duct. * Offer referral for bile duct clearance and laparoscopic cholecystectomy — although of asymptomatic gallstones was likely to have a higher risk than leaving them untreated as all of the treatment options carry risks of adverse effects [NICE, 2014]. * EASL advises that an exception is asymptomatic people with porcelaingallbladder who may be considered for cholecystectomy, as a relatively high percentage of people develop gallbladder carcinoma (reported in some studies). Where porcelain
Non-Anatomic Hepatic Resection Using Chang’s Needle for PorcelainGallbladder We present a simple technique of nonanatomic resection of liver parenchyma for porcelaingallbladder infiltrating gallbladder bed, that is, segments IVb and V of the liver. The resection has been carried out with the use of straight 18-gauge stainless steel multi-use needle designed for hepatic resections (Chang's
with a higher incidence of GBC. Gallstones are the strongest risk factor29; others include porcelaingallbladder, gallbladder polyps, PSC,30,31 chronic Salmonella typhi or Helicobacter bilis infection,32 congenital biliary tree malformations (e.g. choledochal cysts, congenital biliary dilatation and anomalous pancreaticobiliary ductal junction)33 and obesity.34DIAGNOSIS, PATHOLOGY and MOLECULAR
an evaluation for heart failure, hepatic metastases, or Budd-Chiari syndrome.” – From Uptodate 2017.5) What is the significance of a calcified gallbladder?Porcelaingallbladder, most often in elderly women. May be palpable, but isn’t usually tender. Most should be referred for surgical removal due to the high incidence of associated cholangiocarcinoma.This post was uploaded and copyedited by Andrew Guy
episodes of cholecystitis. This is called a porcelaingallbladder and may become malignant.Renal calculi tend to obstruct at certain sites, especially the pelvi-ureteric junction, brim of the pelvis and vesico-ureteric junctions.[11]In the pelvic region, bladder calculi may occasionally be seen. Bladder stones are usually quite large and often multiple. Calcification of a bladder tumour may also occur
, abscess, empyema, infarction, or gangrene may develop in acute cholecystitis, causing peritonitis and threatening the patient's life. Chronic cholecystitis may lead to acute hydrops, acute cholecystitis, or, more insidiously, porcelain gallbladder.The well-known radiographic finding of porcelaingallbladder is caused by chronic calcium deposition in the wall of the gallbladder as a result of inflammation. Although early studies reported a 12-60% incidence of carcinoma arising in the gallbladder wall of patients with porcelaingallbladder, more recent data suggest that the cancer risk is significantly lower (approximately 7% in one large series). [3] Previous Next: EtiologyChronic cholecystitisChronic cholecystitis is most often related to gallstone disease but has been documented without
have gallstones and can develop a calcified gallbladder wall with focal thickening. [20] Calcified gallbladders, also known as porcelaingallbladders, have a high frequency (up to 22%) of association with adenocarcinoma. In patients with calcified gallbladders or with suspected biliary cancer, further imaging and workup are indicated.If gallbladder cysts or masses are identified, patients should
, and the diagnosis and grade of dysplasia were confirmed. The clinical information was obtained from the electronic medical records. Of the 37 cases with dysplasia, 10 (27%) had high-grade dysplasia (HGD) and the remaining showed low-grade dysplasia (LGD). All 4 cases of adenocarcinoma had some gross abnormalities (such as porcelaingallbladder, or ruptured, thickened, and roughened walls, or a granular mucosa
. The annual incidence of GBC was 0.2/100 000 (men: 0.1/100 000; women: 0.3/100 000). Biliary colic and acute cholecystitis were the main presentations. Diagnosis of GBC was "incidental" in 67% of cases. About 75% of patients with GBC had gallstones, 13% had polyps, and 3% had porcelaingallbladder. Adenocarcinoma was the dominant (87%) histologic type. The GBC rate in our region, similar to others parts
was performed to investigate the outcomes of the IU incision and PU incision in laparoscopic cholecystectomy. Study subjects were patients who received laparoscopic cholecystectomy for acute or chronic cholecystitis, gallbladder polyp or adenomyomatosis, or porcelaingallbladder from June 2014 to January 2015. Enrolled subjects were randomly allocated to the IU incision group or the PU incision group