Diagnosis and Surgical Treatment of Xanthogranulomatous Cholecystitis(A Report of 25 Cases)

Objective To investigate diagnosis and surgical treatment of xanthogranulomatous cholecystitis(XGC).Methods The clinical data of 25 patients with pathologically diagnosed XGC admitted during Jan.2001 and May.2009 were retrospectively analyzed.Results The 25 patients did not have definite preoperative diagnosis,and all the patients were examined by B-Ultrasound,17 by CT,5 by MRI.3 patients were misdiagnosed as having gallbladder cancer,22 patients having cholecystolithiasis with cholecystitis.According to the intraoperative findings: thickening of the gallbladder wall was found in all patients,peri-gallbladder invading of Xanthogranulomatous tissue was found in 23 patients,coexistence of cholecystolithiasis was present in 22 patients,Mirizzi syndrome was observed in 4 patients,4 patients were complicated by gallbladder fistula.Open cholecystectomy was performed in 13 patients,greater partical cholecystectomy were undertaken in 4 patients.In addition,cholecystectomy and duodenal fistula repair were undertaken in 3 patients,radical resection of gallbladder cancer in 2 patients,common bile duct exploration and T tube drainage in 2 patients,colectomy in 1 patient.17 of the patient confirmed diagnosis by frozen section pathological examination during operation.All patients were confirmed with definite diagnosis by pathological examination.2 patients suffered from bile leak and 5 patients from incision infection.Conclusion XGC is a rare and special type of chronic cholecystitis,which is difficult to be diagnosed preoperatively,and is very likely to be diagnosed as gallbladder cancer.Definite diagnosis of XGC depends on pathological examination.The basic method of treatment is cholecystectomy.