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Xanthogranulomatous cholecystitis: 15 years' experience
1Department of General Surgery, Mexican Institute of Social Security, Regional General Hospital No 1 Gabriel Mancera, Amores 43 B-105, Col. del Valle, CP 03100 Mexico City, Mexico. guzvaldi@yahoo.com
World Journal of Surgery
|February 13, 2004
Summary
Xanthogranulomatous cholecystitis (XGC) is a rare gallbladder inflammation affecting older males. Its thickened wall can complicate surgery and mimic cancer, necessitating intraoperative examination.
Area of Science:
- Gastroenterology
- Surgical Pathology
- Abdominal Imaging
Background:
- Xanthogranulomatous cholecystitis (XGC) is an uncommon inflammatory condition of the gallbladder.
- Its clinical presentation often mimics acute cholecystitis, posing diagnostic challenges.
Purpose of the Study:
- To review the demographic and clinical features of XGC.
- To analyze associated conditions, surgical outcomes, and diagnostic considerations.
Main Methods:
- Retrospective review of 12,426 cholecystectomy cases over 15 years.
- Inclusion of 182 patients with histopathologically confirmed XGC.
- Analysis of clinical data, imaging findings (ultrasonography, CT), and intraoperative/histopathologic results.
Main Results:
- XGC accounted for 1.46% of cholecystectomies, predominantly in males over 32 years (2:1 ratio).
- Gallbladder wall thickening was universal (100%); 17% presented acutely, 23% had obstructive jaundice.
- Associated with gallstones (85%), Mirizzi syndrome, and rarely malignancy (3%); 65% of cases involved surgical difficulty, with 35% requiring partial cholecystectomy.
Conclusions:
- XGC presents with thickened gallbladder walls, complicating cholecystectomy.
- Intraoperative histologic examination is crucial for differentiating XGC from adenocarcinoma to guide optimal surgical management.