Summary
Background/objective
Xanthogranulomatous cholecystitis (XGC) is a rare inflammatory disease of the gallbladder characterized by a focal or diffuse destructive inflammatory process. The aim of this study was to identify the common clinical and surgical characteristics of XGC patients.
Methods
The records of all cases of XGC histopathologically diagnosed between January 2009 and March 2014 at the Antalya Training and Research Hospital, Antalya, were analyzed retrospectively for collection of data regarding clinical and histopathological characteristics, imaging and surgical findings, comorbidities, nature and duration of surgery, additional procedures performed, and postoperative complications.
Results
The incidence of pathologically diagnosed XGC among the 5765 patients who had undergone cholecystectomy during the study period was 0.95 % (55 patients). The incidence of elevated liver enzymes and elevated bilirubin levels was 25.5 % (14 patients) and 14.5 % (8 patients), respectively. Laparoscopic cholecystectomy could be performed for 45.5 % of cases (25 patients), while the remaining 54.5 % cases (30 patients) required open cholecystectomy. All cases were pathologically characterized by a focal or diffuse destructive inflammatory process that produced varying proportions of lipid-laden macrophages, inflammatory cells, and fibroblasts and by the presence of foam cells and xanthomatous changes. The incidence of postoperative wound infection and wound gaping was 18.2 % (10 patients) and 1.8 % (1 patient), respectively.
Conclusion
Although XGC is a rare condition with a low mortality rate, its treatment is associated with a relatively high incidence of postoperative wound infections and other complications, a fact that should be considered when deciding on the ideal surgical option.
Similar content being viewed by others
References
Yang T, Zhang BH, Zhang J, Zhang YJ, Jiang XQ, Wu MC. Surgical treatment of xanthogranulomatouscholecystitis: experience in 33 cases. Hepatobiliary Pancreat Dis Int. 2007;6:504–8.
Benbow EW. Xanthogranulomatous cholecystitis. Br J Surg. 1990;77:255–6.
Christensen AH, Ishak KG. Benign tumours and pseudotumours of the gall bladder. Arch Pathol. 1970;90:423–32.
Lee KC, Yamazaki O, Horii K, et al. Mirizzi syndrome caused by xanthogranulomatouscholecystitis: report of a case. Surg Today. 1997;27:757–61.
Yoshida J, Chijiiwa K, Shimura H, et al. Xanthogranulomatous cholecystitis versus gallbladder cancer: clinical differentiating factors. Am Surg. 1997;63:367–71.
Spinelli A, Schumacher G, Pascher A, et al. Extended surgical resection for xanthogranulomatouscholecystitis mimicking advanced gallbladder carcinoma: a case report and review of literature. World J Gastroenterol. 2006;12:2293–6.
Eriguchi N, Aoyagi S, Tamae T, et al. Xanthogranulomatouscholecystitis. Kurume Med J. 2001;48:219–21.
McCoy JJ, Jr., Vila R, Petrossian G, McCall RA, Reddy KS. Xanthogranulomatous cholecystitis. Report of two cases. J S C Med Assoc. 1976;72:78–9.
Casas D, Pérez-Andrés R, Jiménez JA, et al. Xanthogranulomatous cholecystitis: a radiological study of 12 cases and review of the literature. Abdom Imaging. 1996;21:456–60.
Houston JP, Collins MC, Cameron I, et al. Xanthogranulomatous cholecystitis. Br J Surg. 1994;81:1030–2.
Valdivia GG. Xanthogranulomatous cholecystitis. An experience of 15 years. World J Surg. 2004;8:254–7.
Uchiyama K, Ozawa S, Ueno M, et al. Xanthogranulomatous cholecystitis: the use of preoperative CT findings to differentiate it from gallbladder carcinoma. J Hepatobiliary Pancreat Surg. 2009;16:333–8.
Goshima S, Chang S, Wang JH, Kanematsu M, Bae KT, Federle MP. Xanthogranulomatous cholecystitis: diagnostic performance of CT to differentiate from gallbladder cancer. Eur J Radiol. 2010;74:e79–83.
Ghosh M, Sakhuja P, Agarwal AK. Xanthogranulomatous cholecystitis: a premalignant condition? Hepatobiliary Pancreat Dis Int. 2011;10:179–84.
Rao RV, Kumar A, Sikora SS, Saxena R, Kapoor VK. Xanthogranulomatous cholecystitis: differentiation from associated gall bladder carcinoma. Trop Gastroenterol. 2005;26:31–3.
Alvi AR, Jalbani I, Murtaza G, Hameed A. Outcomes of xanthogranulomatous cholecystitis in laparoscopic era: a retrospective cohort study. J Minim Access. 2013;9:109–15.
Conflict of interest
None
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kosar, M., Ongen, A., Karakas, B. et al. Xanthogranulomatous cholecystitis: an analysis of 55 cases. Eur Surg 46, 273–276 (2014). https://doi.org/10.1007/s10353-014-0289-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10353-014-0289-1