Treatment of Porcelain Gallbladder with Symptoms or Complications
Symptomatic porcelain gallbladder — or porcelain gallbladder presenting with active disease complications — warrants a defined surgical management strategy, even when malignancy has not been confirmed.
This protocol applies to patients with porcelain gallbladder who present with symptoms or complications of gallbladder disease, such as right hypochondrial pain, common duct obstruction, cholangitis, or recurrent pancreatitis. The presence of these features supports a recommendation for surgical management in this population.
Management centres on surgical removal of the gallbladder. Pathological assessment of the specimen is an integral part of the operative approach — the complete structured evidence-based regimen is available via the link below.
References
DOI: 10.3390/diagnostics11061073
If these PGB patients are symptomatic, or have gallbladder disease complications, even in the absence of malignancy, surgical management should be suggested.
In conclusion, considering the surgical approach, the following factors should be evaluated: (1) symptoms or complications of gallbladder disease such as right hypochondrial pain, common duct obstruction, cholangitis or recurrent pancreatitis; (2) calcification pattern, i.e., selective mucosal type versus complete intramural type and (3) patient's age and comorbidities.
While surgeons perform cholecystectomy, it is essential to subject the surgical specimen to a frozen section and perform histopathological examinations.
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