The surgical management of
porcelain gallbladder is based on studies performed in 1931 and 1962, which indicated a correlation between
porcelain gallbladder and
carcinoma. We sought to evaluate the characteristics of patients with
porcelain gallbladder and the risk for gallbladder
carcinoma. The medical records of 10,741
cholecystectomies performed between 1955 and 1998 were reviewed and recorded. The pathology slides were evaluated for evidence of calcification and gallbladder
carcinoma. Fifteen (0.14%) of 10,741 specimens were
porcelain gallbladders. Ten patients (67%) had symptoms suggestive of biliary
colic or
cholecystitis. Five (33%) were asymptomatic and diagnosed incidentally. All specimens demonstrated chronic
cholecystitis and partial calcification of the gallbladder wall. Nine (60%) had
cholelithiasis. None had gallbladder
carcinoma by recent review of pathologic material. During this same period 88 (0.82%) patients had gallbladder
carcinoma, none of which showed calcification of the wall. This report represents the largest modern review of
porcelain gallbladders. No
carcinoma was identified among patients with
porcelain gallbladder. In addition no patient with gallbladder
carcinoma had calcified gallbladder. With a better understanding of the natural history of the
porcelain gallbladder the current management of these patients may change.