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首页> 外文期刊>Surgical Endoscopy >Xanthogranulomatous cholecystitis: a review of 31 patients
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Xanthogranulomatous cholecystitis: a review of 31 patients

机译：黄色霉素胆囊炎：综述31例患者

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Background Xanthogranulomatous cholecystitis (XGC) is a rare inflammatory gallbladder disease which is difficult to diagnose and treat; XGC may be confused with gallbladder cancer. The present study aimed to evaluate the clinical and radiological features and surgical outcomes, with the aim to determine the appropriate treatment approaches for XGC. Methods This retrospective study analyzed the clinical characteristics, intraoperative findings, and postoperative outcomes of 31 patients (2.0%) who were diagnosed with XGC based on histopathological findings among 1513 patients who underwent cholecystectomy at our hospital between January 2010 and July 2019. Results Preoperative ultrasonography and computed tomography findings indicated acute cholecystitis, chronic cholecystitis, and suspicious XGC in 26 (83.9%) patients with thickening of the gallbladder wall and suspicious gallbladder cancer in 5 (16.1%) patients. Abdominal pain and jaundice were observed in 18 (58.1%) patients and 5 (16.1%) patients, respectively. Biliary drainage before surgery was performed in 21 (67.7%) patients. Laparoscopic cholecystectomy, which was performed in 23 (74.2%) patients, was converted to open cholecystectomy in 12 (52.2%) of these 23 patients. Among the patients with other diseases treated during the study period, laparoscopic cholecystectomy was performed in 1377 patients and converted to open surgery in 71 (5.2%) patients. Five patients with suspicious gallbladder cancer underwent open surgery. In these patients, intraoperative frozen section analysis was useful in distinguishing between XGC and gallbladder cancer and was important in avoiding unnecessarily extended surgery. Conclusion Laparoscopic cholecystectomy for XGC is possible, but often difficult due to severe inflammation. The frequency of conversion to open surgery is higher in patients with XGC than those with other forms of cholecystitis. XGC may resemble gallbladder cancer based on the diagnostic imaging findings, and intraoperative frozen section analysis is essential to avoid unnecessarily extended surgery.
机译：背景黄色肉芽肿性胆囊炎（XGC）是一种罕见的炎症性胆囊疾病，诊断和治疗难度较大；XGC可能与胆囊癌混淆。本研究旨在评估XGC的临床和放射学特征及手术结果，以确定合适的治疗方法。方法该回顾性研究分析了我院2010年1月至2019年7月1513例胆囊切除术患者中31例（2.0%）根据组织病理学检查结果诊断为XGC的临床特征、术中表现和术后结果。结果术前超声和CT检查显示26例（83.9%）患者患有急性胆囊炎、慢性胆囊炎和可疑XGC，5例（16.1%）患者患有可疑胆囊癌。腹痛和黄疸分别见于18例（58.1%）和5例（16.1%）。术前胆道引流21例（67.7%）。23例（74.2%）患者行腹腔镜胆囊切除术，其中12例（52.2%）转为开腹胆囊切除术。在研究期间接受治疗的其他疾病患者中，1377例患者进行了腹腔镜胆囊切除术，71例（5.2%）患者转为开放手术。五名可疑胆囊癌患者接受了开放手术。在这些患者中，术中冰冻切片分析有助于区分XGC和胆囊癌，并有助于避免不必要的扩大手术。结论腹腔镜胆囊切除术治疗XGC是可行的，但由于严重的炎症，手术难度较大。XGC患者中转开腹手术的频率高于其他类型胆囊炎患者。根据诊断性影像学表现，XGC可能类似于胆囊癌，术中冰冻切片分析对于避免不必要的扩大手术至关重要。

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