Towfigh S, McFadden D W, Cortina G R, Thompson J E, Tompkins R K, Chandler C, Hines O J
University of California Los Angeles Medical Center, Division of General Surgery, 90095, USA.
Am Surg. 2001 Jan;67(1):7-10.
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.
瓷性胆囊的外科治疗基于1931年和1962年开展的研究，这些研究表明瓷性胆囊与癌症之间存在关联。我们试图评估瓷性胆囊患者的特征以及胆囊癌风险。回顾并记录了1955年至1998年间进行的10741例胆囊切除术的病历。对病理切片进行评估，以寻找钙化和胆囊癌的证据。在10741份标本中，有15份（0.14%）为瓷性胆囊。10例患者（67%）有提示胆绞痛或胆囊炎的症状。5例（33%）无症状，为偶然诊断。所有标本均显示慢性胆囊炎和胆囊壁部分钙化。9例（60%）有胆结石。根据近期病理材料复查，无一例有胆囊癌。在同一时期，88例（0.82%）患者有胆囊癌，其中无一例显示胆囊壁钙化。本报告是对瓷性胆囊进行的最大规模现代综述。在瓷性胆囊患者中未发现癌症。此外，没有胆囊癌患者的胆囊有钙化。随着对瓷性胆囊自然病程的更好理解，目前对这些患者的治疗可能会改变。
