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Xanthogranulomatous Cholecystitis: 15 Years’ Experience

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Abstract

The demographic and clinical aspects of xanthogranulomatous cholecystitis (XGC) over a period of 15 years are reviewed. The review entailed examining 12,426 clinical files of patients who had undergone cholecystectomy, including 182 patients with a histopathologic diagnosis of XGC. Altogether, 1.46% of the cholecystectomies performed were done on patients with a diagnosis of XGC. XGC presented in patients over the age of 32, with a male/female ratio of 2:1. Thickening of the gallbladder wall, seen on ultrasonography and computed tomography scans, was demonstrated in 100% of the cases. A total of 17% of the cases presented in acute form. Obstructive jaundice was observed in 23% of the patients, 11 of which cases were associated with choledocholithiasis (30% of these patients had jaundice) and the rest with extrinsic obstruction of the bile tract (Mirizzi syndrome). XGC was associated with lithiasis in 85% of the cases. A malignant lesion was suspected during operation in 30% of the cases, requiring histopathologic examination during surgery. Carcinomatous lesions were found in 3% of the cases. Surgical difficulty was reported in 65% of the cases, resulting in the performance of partial cholecystectomy in 35%. XGC is an infrequent form of chronic inflammation of the gallbladder, the clinical presentation of which is similar to that of cholecystitis; given the thickening of the gallbladder wall, it makes cholecystectomy difficult. As XGC may resemble adenocarcinoma, differentiation is essential by means of intraoperative histologic examination to ensure optimal surgical treatment.

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  1. Department of General Surgery, Mexican Institute of Social Security, Regional General Hospital No 1 “Gabriel Mancera”, Mexico City, Mexico

    Gilberto Guzmán-Valdivia M.D.

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  1. Gilberto Guzmán-Valdivia M.D.
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Correspondence to Gilberto Guzmán-Valdivia M.D..

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Guzmán-Valdivia, G. Xanthogranulomatous Cholecystitis: 15 Years’ Experience. World J. Surg. 28, 254–257 (2004). https://doi.org/10.1007/s00268-003-7161-y

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