MINIMALY INVASIVE METHODS FOR PORCELAIN GALLBLADDER OPERATION drpocevski@gmail.com

 

MINIMALY INVASIVE METHODS FOR PORCELAIN GALLBLADDER OPERATION

2

Serbia

Oral or Poster

Porcelain Gallbladder (PGb) is a rare entity - calcification of gallbladder wall (Calcified Gallbladder or Calcifying Cholecystitis) which is mostly precancerous lession (up to 65%) and prevalence is higher in older female patients (ratio 5:1 in favor to women).

On Surgery Department in ten years was admitted 23 patients (16 female, 7 male). Even though PGb is mostly asymptomatic, 5 patients (21.73%) had pain in right upper quadrant with nausea, and 3 were admitted as urgent patients with biliary colic. Standard procedure were done to 20 patients: X-ray, ultrasound and MDCT of abdomen with laboratory analysis.

Asymptomatic patients (18 of them) were observed and cholecystectomy was scheduled up to 2 months of initial examination. We considered several different possible methods and after preoperative selection it was done 3 classical cholecystectomies with incision up to 10 cm, 7 conventional minilaparotomy cholecystectomy with skin incision up to 8 cm, 3 minilaparotomy cholecystectomy with skin incision up to 6 cm, and 10 microlaparotomy cholecystectomy with skin incision up to 4 cm, all with transrectal longitudinal incision.

After carefully preoperative selection it is crucial for younger surgeons to consider minimally invasive operative procedures because of many benefits and in such cases when laparoscopy is not possible. Also, it is mostly satisfied for surgeon when such casuistic is removed before malignant transformation.