Porcelain gallbladder
A gallbladder whose wall has turned hard and chalky with calcium after years of inflammation, seen on a scan or X-ray. It was long thought to lead to cancer in many cases; newer studies find the risk is real but much smaller, so whether to remove a symptom-free porcelain gallbladder is now a judgement call.
Overview
Porcelain gallbladder is calcification of the gallbladder wall, usually with gallstones and chronic cholecystitis. Cancer Research UK quotes about eight times the general population risk of gallbladder cancer, citing Schnelldorfer's 2013 systematic review, which found cancer in 72 of 340 reported patients (21 percent) overall but only 6 percent in the 13 studies without obvious selection bias, against 1 percent in matched controls (relative risk 8.0, confidence interval 1.0 to 63); the only independent predictors of cancer were symptoms typical of gallbladder cancer and a gallbladder mass, which mark advanced disease rather than help screening. A 2018 single-centre cohort of 113 patients observed 90 without surgery for a mean of 3.2 years: none developed cancer, 4 percent needed a later cholecystectomy for symptoms, and complications in the operated group were 13 percent (DesJardins 2018). Cancer Research UK's patient page says a doctor may suggest removal; many surgeons offer prophylactic cholecystectomy to fit patients, others observe.
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