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Updated: May 10, 2026

The Role of Indocyanine Green Fluorescence in Complex Laparoscopic Cholecystectomy Navigation

The Role of Indocyanine Green Fluorescence in Complex Laparoscopic Cholecystectomy Navigation

Published on: January 31, 2025

Xanthogranulomatous cholecystitis--a diagnostic challenge.

Sujata Jetley¹, Safia Rana, Rehan Nabi Khan

¹Department of Pathology, Hamdard Institute of Medical Sciences and Research, New Delhi 110062.

Journal of the Indian Medical Association

|June 22, 2013

Summary

Xanthogranulomatous cholecystitis is a rare, destructive gallbladder inflammation. It often mimics gallbladder cancer, highlighting the need for careful histological examination post-surgery.

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Last Updated: May 10, 2026

The Role of Indocyanine Green Fluorescence in Complex Laparoscopic Cholecystectomy Navigation

The Role of Indocyanine Green Fluorescence in Complex Laparoscopic Cholecystectomy Navigation

Published on: January 31, 2025

Area of Science:

Gastroenterology
Surgical Pathology
Abdominal Imaging

Background:

Xanthogranulomatous cholecystitis (XGC) is an uncommon, benign variant of chronic cholecystitis.
It presents as a destructive inflammatory process of the gallbladder, characterized by fibrosis and wall thickening.

Purpose of the Study:

To analyze the clinical presentation, imaging findings, intraoperative observations, and histology of XGC.
To compare these findings with existing literature and emphasize diagnostic challenges.

Main Methods:

Retrospective analysis of 13 histologically confirmed cases of XGC from 217 cholecystectomies (January 2011-March 2012).
Review of clinical, radiological, and operative data.
Histological examination of gallbladder tissue.

Main Results:

XGC incidence was 6% in the study cohort, with a mean age of 40.3 years (female:male ratio 1.6:1).
Chronic right upper quadrant pain was the most common symptom; ultrasound revealed gallbladder wall thickening in 84.6%.
Laparoscopic to open conversion rate was 61.5%; histology showed foamy histiocytes, inflammatory cells, and giant cells.

Conclusions:

XGC is a destructive inflammatory condition that can mimic gallbladder carcinoma due to mass-like presentation and wall thickening.
Pre- and intra-operative differentiation from malignancy remains challenging for surgeons.
Histological assessment of all excised gallbladders is crucial due to the potential coexistence with gallbladder carcinoma.