Categories
Change Password!
Reset Password!
In xanthogranulomatous cholecystitis (XGC)
patients, laparoscopic cholecystectomy is possible but difficult. The
intraoperative frozen section analysis helps to differentiate XGC and gall
bladder cancer.
As per recent study findings, it was concluded that for managing XGC patients, laparoscopic cholecystectomy is possible, but often cumbersome due to the presence of severe inflammation. Compared to other forms of cholecystitis, the frequency of conversion to open surgery is greater in patients with XGC.
Based on the clinical and diagnostic imaging findings, XGC may substantially resemble gallbladder cancer. To prevent unnecessarily extended surgery, the intraoperative frozen section analysis is pivotal to differentiate XGC and gall bladder cancer.
The diagnosis and treatment of XGC, a rare inflammatory gallbladder disease, is challenging. The present study aimed to evaluate the clinical and radiological features and surgical outcomes, to assess the appropriate treatment approaches for managing XGC patients.
A retrospective study was conducted to analyze the clinical characteristics, intraoperative findings, and postoperative outcomes in XGC patients. Among 1513 patients who underwent cholecystectomy between January 2010 and July 2019, 31 patients diagnosed with XGC based on histopathological findings were analyzed.
Based on preoperative ultrasonography and computed tomography findings, the no. of patients in which acute and chronic cholecystitis, and suspicious XGC and thickening of the gallbladder wall and suspicious gallbladder cancer was seen is shown in the following table:
The no. of patients in which abdominal pain and jaundice were noted is depicted in the following table:
In 21 (67.7%) patients, the biliary drainage prior to surgery was conducted. Laparoscopic cholecystectomy, which was carried out in 23 (74.2%) patients, was converted to open cholecystectomy in 12 (52.2%) of patients. Among the patients with other diseases treated during the analysis, the laparoscopic cholecystectomy was carried out in 1377 patients and converted to open surgery in 71 (5.2%) patients.
Open surgery was performed in five patients with suspicious gallbladder cancer. In these individuals, the intraoperative frozen section analysis was beneficial for differentiating between XGC and gallbladder tumour and was crucial for preventing unnecessarily extended surgery.
Thus, laparoscopic cholecystectomy is possible but difficult in XGC patients.
Surgical Endoscopy
Xanthogranulomatous cholecystitis: a review of 31 patients
Shinichiro Makimoto
Comments (0)