A CASE OF PORCELAIN GALLBLADDER AND REVIEW OF 100 CASES IN JAPAN

Porcelain gallbladder has been considered a rare disease, and the review of Japanese literature by Kanno et al. indicated only 55 cases between 1937 and 1979. In the present study, a case of porcelain gallbladder with limy bile is reported, and a review of 100 reported cases in Japan is presented. A 56-year-old male visited our hospital with the chief complaint of abdominal pain. The final diagnosis was por-celain gallbladder and cholecystectmy was carried out. A stone was impacted in the neck of the gallbladder and limy bile was also found around it. The major component of the calcified layer of the gallbladder wall, analysed by infrared spectra, was calcium phosphate. Reviewing 100 cases reported in Japan revealed the followings: The male-to-female ratio was approximetely 1:4, and the age ranged mostly from 50s to 70s. Abdominal pain was the most common clinical symptom, but no symptoms charactaristic of this disease were found. The occurrence rate of stone with porcelain gallbladder was 78%. Ob-struction of the cystic duct due to chronic inflammation or impaction by stone was found in almost all cases. Moreover, the carcinoma of the gallbladder was observed in a ratio of about 11%. These results suggest that a careful examination should be performed preoperatively and cholecystectomy should be undertaken.