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Laparoscopic Cholecystectomy with Indocyanine Green Fluorescence: Choledochoscopic Stone Extraction and Primary Duct Suture
Published on: November 25, 2025
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Porcelain Gallbladder: No Longer an Indication for Prophylactic Cholecystectomy
Gao L Chen1, Yasir Akmal, Andrew L DiFronzo
1Kaiser Permanente Los Angeles Medical Center, Los Angeles, California, USA.
The American Surgeon
|October 15, 2015
Summary
Porcelain gallbladder (PG) does not increase gallbladder cancer (GBC) risk. Cholecystectomy in asymptomatic PG patients leads to high complication rates, not cancer prevention.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Radiology
Background:
- Porcelain gallbladder (PG) has been historically linked to gallbladder cancer (GBC).
- Cholecystectomy is frequently performed for PG, despite evolving understanding of its risks.
Purpose of the Study:
- To determine the incidence of GBC in patients with radiographic diagnosis of PG.
- To evaluate the outcomes of cholecystectomy versus observation in PG patients.
Main Methods:
- Retrospective chart review of 192 patients with radiographic PG diagnosis (2008-2013).
- Analysis of patient demographics, symptoms, surgical/observational outcomes, and pathology results.
Main Results:
- No GBC was found in 102 surgically treated patients or 90 observed patients.
- Asymptomatic PG patients undergoing surgery had a 10.7% perioperative complication rate.
- Symptomatic PG patients had a 16.7% complication rate, with 5% conversion to open surgery.
Conclusions:
- Porcelain gallbladder is not associated with an increased risk of gallbladder cancer.
- Cholecystectomy in asymptomatic PG patients carries significant postoperative complication risks.
- Cholecystectomy is not recommended for asymptomatic porcelain gallbladder.
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