Porcelain gallbladder patients have an increased risk of developing gallbladder cancer and require surgery. The type of surgery depends on the severity of the condition, which is classified based on ultrasound imaging. Types II and III require open cholecystectomy, while type I can sometimes be treated with laparoscopic cholecystectomy. The condition is often diagnosed incidentally through imaging studies.
Patients with the inflammatory condition known as porcelain gallbladder are at increased risk of developing gallbladder cancer. For this reason, the disease should be treated with surgery to remove the gallbladder. The type of surgery used for removal can vary based on the patient’s clinical presentation of the disease.
The mainstay of treatment for this condition is a cholesitectomy, which is surgery performed to take out the gallbladder. The reason surgery is needed in patients with this condition is that it is often associated with gallbladder cancer. As many as one third of patients diagnosed with porcelain gallbladder have coexisting gallbladder cancer. The other two-thirds have a higher risk of developing gallbladder cancer than the general population.
In cases of porcelain gallbladder, how surgical removal is done depends on the pattern of disease present. The condition is classified based on the appearance of the gallbladder on ultrasound, an imaging technique that uses sound waves to reveal characteristics of structures within the body. Ultrasound is a useful way to diagnose this condition because it easily detects calcification located in the wall of the gallbladder. Three models, types I-III, were identified based on their sonographic characteristics.
Porcelain gallbladder types II and III are considered the most dangerous types. Early surgery is recommended for patients who fall into these two categories. Most of the time an open cholecystectomy is required. This means that the surgeon performing the operation will make a 5 to 7 inch (about 13 to 18 centimeters) incision or cut in the upper abdomen on the right side. Making a large incision allows the surgeon to see the gallbladder more clearly and to remove it more accurately.
Unlike types II and II, type I porcelain gallbladder is less severe and can sometimes be treated with less invasive surgery. A laparoscopic cholecystectomy is often sufficient in these patients. With this procedure, three small incisions are made in the abdomen. A camera probe is inserted through one incision and surgical tools are used to access the gallbladder through the other two incisions. The benefits of a laparoscopic cholecystectomy are a shorter recovery time and a reduced risk of bleeding and infection.
The porcelain gallbladder is often diagnosed incidentally. In other words, imaging studies performed for other reasons detect the anomaly. Imaging techniques such as abdominal computed tomography (CT), abdominal X-ray, or abdominal ultrasound easily show diseased gallbladder. The condition is called a “porcelain” gallbladder due to the calcifications present in its wall. Often the condition develops from chronic inflammation of the gallbladder, such as from chronic cholecystitis.
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