IT IS apparent to many physicians that there exists a group of diseases of the gallbladder which require surgery for functional and anatomic disease, but where the diagnosis of cholecystitis or cholelithiasis is not substantiated by pathological examination. In 1960, Jutras, following earlier work by Albot, made the observation that these conditions shared three abnormalities of function demonstrable by cholecystography: hyperconcentration, hyperexcitability, and hyperexcretion.1,2 Furthermore, the anatomic alterations noted were repeatable; each gallbladder showed mucosal imbibition of cholesterol and proliferation of all elements of the gallbladder wall. The term hyperplastic cholecystosis was therefore applied to these cases. Predominance of one or another of the mural elements was used to make a simple subclassification into cholesterolosis, diffuse and polypoid; adenomyomatosis, generalized, segmental, and localized; and neuromatosis, superficial and deep. Infiltration of the wall by calcium, fat, and proliferation of fibrous or elastic tissue can be used for further subdivision: calsinosis,