Cell Biochemistry and Biophysics

, Volume 64, Issue 2, pp 131–135

Diagnosis and Treatment of Xanthogranulomatous Cholecystitis: A Report of 39 Cases

Original Paper

DOI: 10.1007/s12013-012-9381-y

Cite this article as:
Han, SH. & Chen, YL. Cell Biochem Biophys (2012) 64: 131. doi:10.1007/s12013-012-9381-y

Abstract

This study focuses on providing diagnosis and treatment for xanthogranulomatous cholecystitis (XGC). Clinical data from 39 patients diagnosed with XGC by pathological examination between 2002 and 2010 were analyzed retrospectively. As a result, in this group of patients, the male to female ratio was 30:9 and the average age of XGC onset was 62.2 years. Clinical manifestation of the disease was similar to general cholecystitis and preoperative CT examination showed that there were only 4 XGC cases, while the others were possibly misdiagnosed. Intraoperative observations showed that all the patients had gallbladder wall thickening. This was associated with gallbladder stones in 37 patients (94.9 %), choledocholith in 11 patients (28.2 %), and Mirizzi syndrome in 5 patients (12.8 %). In this study, intraoperative frozen section pathology was conducted in 14 patients and no gallbladder cancer was found. Laparoscopic cholecystectomy was performed on 7 patients, of which two were transferred to laparotomy. Of the remaining 32 cases, 25 were subjected to open cholecystectomy, 3 to partial cholecystectomy, and 4 to the cholecystectomy and partial liver wedge resection. It was concluded that XGC is a unique type of cholecystitis with atypical clinical manifestations and is often difficult to diagnose preoperatively. Pathological examination is a key to diagnose XGC and cholecystectomy is the primary surgical treatment. In patients with choledochectasia or jaundice, for whom we cannot exclude calculus of common bile duct, common bile duct exploration should be considered. The prognosis of XGC appears to be good with the above approaches.

Keywords

Xanthogranulomatous cholecystitis Gallbladder stones Cholecystectomy 

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of Hepatobiliary SurgeryThe Affiliated Union Hospital of Fujian Medical UniversityFuzhouPeople’s Republic of China
  2. 2.Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Research Center of Molecular MedicineFujian Medical UniversityFuzhouPeople’s Republic of China

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