巨大胆石に対する胆嚢摘出術から得られた教訓

Giant gallstones are a rare phenomenon that may pose technical challenges for surgeons. We describe the case of an 81-year-old female who presented to our regional health service with acute cholecystitis and a computed tomography (CT) scan demonstrating a possible porcelain gallbladder. Her index presentation was conservatively managed with intravenous antibiotics due to body habitus and concerns for the porcelain gallbladder, with a good clinical response. She subsequently underwent an elective laparoscopic cholecystectomy which was converted to an open approach due to technical challenges. She was found to have a chronically inflamed gallbladder containing a giant gallstone. We report our successful management of a chronically inflamed gallbladder involving a giant gallstone. We also explore diagnostic considerations and surgical approaches to tackle the technical challenges we encountered in this case.