Laparoscopical Resection of a Porcelain Gallbladder: A Case Report

Abstract

The patient was a 61-year-old man with calcification of the gallbladder wall that was discovered at a routine medical examination, and the patient was referred to our hospital. Abdominal ultrasound and CT revealed circumferential calcification in the gallbladder and a calculus in the neck of the gallbladder. The patient was diagnosed with porcelain gallbladder (PGB) and cholelithiasis and underwent laparoscopic cholecystectomy. In surgery, grasping with forceps was difficult due to calcification of the wall. Thus, a small hole was made in the fundus of the gallbladder, and the gallbladder was grasped and elevated. There was severe fibrosis due to inflammation. However, dissection of Calot's triangle and exposure and clipping of the cystic duct and cystic artery were safely performed. A histopathologic examination revealed hyaline fibrosis of the entire gallbladder wall. There were not neoplastic changes. PGB is a relatively rare disease, and it has been previously associated with gallbladder cancer. It has been reported that cancer was found in 7% of PGB patients with partial calcification of the gallbladder but in 0% of PGB patients with total calcification such as our patient.The laparoscopic procedure in our study is a treatment option that can be used in cholecystectomy depending on the degree of calcification.