A plain abdominal radiograph of a 52-year-old woman with chronic right hypochondrial discomfort shows a rim-like curvilinear calcification outlining the gallbladder wall. Ultrasound confirms the finding and shows no stones or mass. What is the standard recommendation regarding this finding?
- A Cholecystectomy is advised, particularly for diffuse (complete) mural calcification, because of the reported association with gallbladder carcinoma ✓
- B Observation only, since the association with carcinoma has been disproven entirely
- C Annual surveillance ultrasound for life without surgery
- D Immediate radical cholecystectomy with wedge liver resection and lymphadenectomy
Explanation
Porcelain gallbladder, diffuse calcification of the gallbladder wall, has traditionally carried a substantial risk of harbouring carcinoma, quoted between roughly 10 and 25 percent in older series, so elective cholecystectomy is advised, especially when calcification is complete and circumferential. Newer data suggest lower risk, particularly with selective mucosal calcification, but the conventional teaching and Indian exam answer remains prophylactic cholecystectomy. Radical resection is reserved for proven cancer, and lifelong surveillance without surgery is not standard practice.
Reference: Bailey and Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.