Research Article

An Analysis of Xanthogranulomatous Cholecystitis Cases

10.1501/Tıpfak_000001003

  • Serhat Tokgöz
  • Muzaffer Akkoca
  • Demet Yılmazer
  • Șener Balas
  • Cem Azılı
  • Kerim Bora Yılmaz
  • Ahmet Oğuz Hasdemir

Received Date: 11.10.2017 Accepted Date: 02.11.2017 J Ankara Univ Fac Med 2018;71(1):81-86

Aim:

Xanthogranulomatous cholecystitis (XGC) is usually an inflammatory condition due to gallstones and bile stasis. Pathological, radiological and clinical features are similar to gallbladder cancer, leading to erroneous treatments such as excessive or inadequate surgery. The aim of this study was to identify the clinical and surgical characteristics of XGC cases.

Materials and Methods:

The medical records were reviewed of 55 patients diagnosed as XGC from 4818 patients who underwent cholecystectomy between 2008 and 2015.

Results:

The most common clinical finding (90%) was right upper quadrant pain, followed by acute cholecystitis (30%). Biliary wall thickening was found in 64% of patients. Conversion to open cholecystectomy rate was 39%, which was significantly higher than that of all cholecystectomies conversion rates 3.4%. Postoperative biliary fistula was determined at 9% and total morbidity at 23%.

Conclusion:

XGC is a rare form of cholecystitis. Although it is histologically benign, preoperative and intraoperative diagnosis is difficult and complicated due to its aggressive course. Although carcinoma may be suspected during surgery in XGC, the association is not very high. It is quite useful to study frozen samples to avoid extensive surgery. The definitive treatment is surgery, but it should not be forgotten that there are high morbidity rates during and after the operation.

Keywords: xanthogranulomatosis, cholecystitis, conversion cholecystectomy