a) Mortality more than that of calculus cholecystitis
b) GB rupture chances are more
c) Immediate cholecystectomy is the treatment of choice
d) Only A & B are correct
The disease process is generally more fulminant than that of calculous cholecystitis and may progress to gangrene and perforation of the gallbladder.
Treatment of acalculous cholecystitis is similar to that of calculous cholecystitis, with cholecystectomy being therapeutic. Given the substantial inflammation and high risk of gallbladder gangrene, an open procedure is generally preferred.
However, many of these patients are critically ill and would not tolerate the physiologic insult of a laparotomy, explaining why the mortality rate of cholecystectomy for acalculous cholecystitis is up to 40%. Accordingly, percutaneous drainage of the distended and inflamed gallbladder is carried out in patients unable to tolerate a laparotomy.
Approximately 90% of patients will improve with percutaneous drainage, and the tube can eventually be removed. If follow-up imaging continues to demonstrate no stones, interval cholecystectomy is generally unnecessary.
A. 80 percent of porcelain gall bladder predispose to malignancy
B. Untreated advanced CA GB median survival is 2-5 months
C. Stippled calcification of mucosa has higher risk of malignancy than diffuse intramural calcification
D. More than 75 percent of CA gall bladder has history of cholelithiasis
69% to 86% of patients with gallbladder cancer have a personal history of gallstone disease.
The presence of an abnormal pancreaticobiliary duct junction, thought to promote chronic biliary inflammation, has been associated with both choledochal cyst disease and gallbladder cancer.
In porcelain gallbladder, risk of ca gb due to chronic inflammation and calcification of the gallbladder wall, was once estimated to be as high as 61%; however, more contemporary analyses suggest that the correct figure is more likely between 7% and 25%