1. Limey (Milk of Calcium) Bile • Precipitated calcium due to secretion of sufficient concentration of calcium salts in the gallbladder lumen • Roentgenography: diffuse, hazy opacification of bile or a layering effect Porcelain Gallbladder • Calcium salt deposition within the wall of a chronically inflamed gallbladder • Associated with the development of gallbladder carcinoma

2. Treatment: Acute Cholecystitis • Medical Therapy Analgesia: NSAIDs / Meperidine Intravenous antibiotic therapy – ureidopenicillin: piperacillin/mezlocillin, ampicillinsulbactam, ciprofloxacin, moxifloxacin, and third-generation cephalosporins. Metronidazole Imipenem/meroponem

3. Treatment: Acute Cholecystitis • Surgical Therapy Cholecystectomy or Cholecystotomy

4. Postcholecystectomy Complications • Cystic Duct Stump Syndrome  Disease in Cystic duct remnant (>1 cm) that presents with symptoms resembling biliary pain or cholecystitis in the absence of cholangiographically demonstrable retained stones on a postchlecystectomy patient