Analysis of Diagnosis and Treatment of Xanthogranulomatous Cholecystitis in 48 Cases

Objective To explore the etiological agent, clinical manifestations, imaging findings, pathologic characteristics, diagnosis, treatment, and prognosis of xanthogranulomatous cholecystitis(XGC). Method The clinical data of 48 patients with XGC diagnosed by postoperative pathology from January 2003 to December 2012 were collected and analyzed. Results In these 48 patients with XGC, the clinical manifestations included 40(83.3%) patients with upper right abdominal pain, 18(37.5%) patients with jaundice, 12(25.0%) patients with fever. B ultrasound examination was performed in 45 cases, in which 42 cases were diagnosed with cholecystitis, 38 cases together with cholecystolithiasis, 15 cases together with cholecystolithiasis and gallbladder neoplasm, and 3 cases together with choledocholith with bile duct dilatation. CT was performed in 30 cases, in which 25 cases were diagnosed with cholecystitis together with cholecystolithiasis, 11 cases were diagnosed with gallbladder neoplasm. MRI was performed in 22 cases, in which 18 cases were diagnosed with cholecystitis together with cholecystolithiasis, 4 cases were diagnosed with gallbladder carcinoma. Thirty-three cases were treated with open cholecystectomy, 9 patients with laparoscopic cholecystectomy, 4 patients with cholecystectomy plus choledocholithotomy and T-tube drainage, 2 patients with cholecystectomy plus partial hepatectomy. All the patients were diagnosed with XGC by postoperative pathology and recovered well without recurrence and canceration. Conclusions XGC is a kind of benign and invasive disease without specific clinical manifestation. Bultrasound, CT, or MRI play an important role in diagnosis, but final diagnosis is mainly based onpathological detection, and surgery is the most effective treatment. The prognosis of XGC is favorable if gallbladder is completely resected.