Porcelain gallbladder describes calcification of the gallbladder wall. Calcification is classified by its extent: the complete intramural type, as in this scenario, differs in clinical significance and management from selective mucosal calcification.

Clinical Scenario

This protocol applies to a patient with complete intramural calcification of the gallbladder wall who is young and fit, currently asymptomatic with no complications of gallbladder disease, and does not carry a high risk of perioperative mortality.

Cholecystectomy is an appropriate option in this population. Conservative management is reserved for patients with high perioperative risk — a consideration that does not apply here.

Surgical Approach

The protocol for this presentation centres on a surgical approach beginning with cholecystectomy. Depending on intraoperative findings, the procedure may require conversion to a more extensive operative strategy. The complete structured algorithm — including all decision points and operative steps — is available in the full protocol.

References

DOI: 10.3390/diagnostics11061073

Calcification of the gallbladder is classified based on its extent: complete intramural calcification and selective mucosal calcification.
In young and fit patients, cholecystectomy is a good option; however, it is not recommended for those who have a high risk of perioperative mortality, and conservative management is better in them.
If this reveals malignancy, conversion to an extended or radical cholecystectomy is needed (wedge resection of the liver and gallbladder bed, followed by lymphadenectomy).

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Complete Intramural Calcification of the Gallbladder Wall in a Young, Fit Patient Without High Perioperative Risk

Clinical Scenario

Surgical Approach

References