Vesícula de porcelana. Caso clínico y revisión de la literatura / Porcelain gallbladder: a clinical case and a review of the literature

Vesícula en porcelana se define como la calcificación de la pared de la vesícula biliar. Es una rara entidad que se observa en el 0,06 a 0,8% de las colecistectomías. Su etiología sigue siendo desconocida. Reportamos dos casos de pacientes con vesícula en porcelana. Un caso es un paciente masculino de 60 años que consulta por sintomatología biliar, se realiza el diagnóstico mediante ecografía y tomografía computada y es intervenido quirúrgicamente realizándose colecistectomía parcial con anatomía patológica que informa: pared vesicular con esclerohialinosis y focos de calcificación distrófica. El otro caso es una paciente femenina de 98 años, cuya forma de presentación fue incidental dado que cursaba con cuadro de oclusión intestinal, se realizó colecistectomía con buena evolución postoperatoria. Series publicadas entre los años 1950 y 1960 avalan que la vesícula en porcelana puede observarse con frecuencia en pacientes con cáncer de vesícula, aunque recientemente se ha desestimando este tipo de relación. El motivo por el cual se presentan estos casos es su baja frecuencia y su controversia en lo que al tratamiento se refiere por su relación con el cáncer de vesícula (AU)

Porcelain bladder is defined as calcification of the gallbladder wall. It is a rare condition and is seen in 0.06% to 0.8% of cholecystectomies. It origin is still unknown. We report two cases of patients with a porcelain gallbladder. One case is a 60 year-old male patient who was seen due to having biliary symptoms. The diagnosis was made by ultrasound and computed tomography, and he was surgically intervened by performing apartial cholecystectomy. The histopathology reported a gallbladder wall with sclerohyalinosis and dystrophic calcification foci. The other case is a 98 year-old female patient, whose form of presentation was incidental given that she suffered from symptoms of an intestinal obstruction. A cholecystectomy was performed with a good post-surgical outcome. A series published in between 1950 and 1960 show that the porcelain bladder can be frequently observed in patients with cancer of the gallbladder, although this relationship is currently being rejected. The reason why these cases are being presented is because of their (AU)

[Porcelain gallbladder: a clinical case and a review of the literature]. / Vesícula de porcelana. Caso clínico y revisión de la literatura.

Porcelain bladder is defined as calcification of the gallbladder wall. It is a rare condition and is seen in 0.06% to 0.8% of cholecystectomies. It origin is still unknown. We report two cases of patients with a porcelain gallbladder. One case is a 60 year-old male patient who was seen due to having biliary symptoms. The diagnosis was made by ultrasound and computed tomography, and he was surgically intervened by performing a partial cholecystectomy. The histopathology reported a gallbladder wall with sclerohyalinosis and dystrophic calcification foci. The other case is a 98 year-old female patient, whose form of presentation was incidental given that she suffered from symptoms of an intestinal obstruction. A cholecystectomy was performed with a good post-surgical outcome. A series published in between 1950 and 1960 show that the porcelain bladder can be frequently observed in patients with cancer of the gallbladder, although this relationship is currently being rejected. The reason why these cases are being presented is because of their low incidence and the controversy over what treatment to use, due to its association with gallbladder cancer.

[Transfistular approach for the treatment of retained biliary stones]. / Abordaje transfistular para el tratamiento de la litiasis residual de la vía biliar.

INTRODUCTION: Residual stones are those persisting in the biliary duct after a surgical intervention. They are found in approximately 2% of cases after a simple cholecistectomy and in 4% to 15% after an exploration of the common duct. MATERIAL AND METHODS: Between January 2009 and June 2008, 81 patients were treated because of residual stones. Age, sex, number of stones, days in the hospital, laboratory, complications and diagnosis were analyzed. RESULTS: Forty-eight patients were male and 33 female. The mean age was 42.5 years. Mean stay at hospital was 1.3 days. The mean number of procedures was 1.19. Fifty-two patients came from another institution and 28 belonged to our institution. The total of complications was 6.5%. CONCLUSIONS: The percutaneous treatment for the residual stones is the goal standard in patients with "T" tube drainage and elevated risk for surgery. The advantage of this procedure is that it is economic, effective and with low risks for the patient. For the treatment of this disease, the collaboration of surgeons, endoscopists, and interventional radiologists is needed.