The patient has a porcelain gallbladder, which can lead to gallbladder cancer in approximately 20% of patients. This patient should undergo a prophylactic cholecystectomy with the goal of preventing development of malignancy. Observation would put the patient at risk for the development of gallbladder cancer. Endoscopic retrograde cholangiopancreatography and endoscopic ultrasound would not change the need for the cholecystectomy. A
cholecystojejunostomy would not be indicated and would leave the gallbladder in place, where cancer could still develop.3
3. Sheth S, Bedford A, Chopra S. Primary gallbladder cancer: recognition of risk factors and the role of prophylactic cholecystectomy. Am J Gastroenterol 2000;95:140210.
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