Xanthogranulomatous cholecystitis: A clinicopathological study from a tertiary care health institution

Kansakar, PBS and Rodrigues, Gabriel and Khan, Sohil Ahmed (2008) Xanthogranulomatous cholecystitis: A clinicopathological study from a tertiary care health institution. Kathmandu University Medical Journal, 6 (4). pp. 472-475.

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Background: Xanthogranulomatous cholecystitis is an unusual and destructive form of chronic cholecystitis and is indistinguishable from other forms of cholecystitis which makes preoperative diagnosis and surgery dif� cult. Objectives: To review the demographic and clinical aspects of xanthogranulomatous cholecystitis; to study the possibility of preoperative diagnosis and to identify the causes for dif� cult surgery. Materials and methods: All cases histopathologically diagnosed as xanthogranulomatous cholecystitis over a period of six years from October 1999 to September 2005 at Kasturba Medical College Hospital, Manipal, India were included in the study. Data of the patients was collected retro and prospectively. Results: A total of 615 patients underwent cholecystectomy out of which 33 (5.2%) were diagnosed to have xanthogranulomatous cholecystitis. Ultrasound abdomen showed gallbladder wall thickening in 19 (57.5%) cases and gallstones in 32 (96.9%) cases. Thirty (90.9%) underwent open cholecystectomy. Gallbladder could be removed totally in 25 (75.6%) cases whereas � ve (15.2%) had to undergo partial cholecystectomy and in one patient, only cholecystostomy could be performed due to dense adhesions. Laparoscopic cholecystectomy was attempted in 11 patients but successful only in two patients with a conversion rate of 81.8%. Postoperative wound infection was seen in � ve (15.1%) patients and one (3%) had minor biliary leak which was treated conservatively. Histologically, xanthogranulomatous cholecystitis was associated with malignancy in one (3.03%) patient. There was no mortality. Conclusion: Clinical presentation of xanthogranulomatous cholecystitis was indistinguishable from chronic cholecystitis. Ultrasonography may reveal only non speci� c � ndings of calculi and thickened gall bladder wall. Hence preoperative diagnosis is unlikely. Cholecystectomy was usually dif� cult owing to dense adhesions of gallbladder and Calot’s triangle. Conversion rate of laparoscopic cholecystectomy is higher. Morbidity associated with surgery is signi� cant.

Item Type: Article
Uncontrolled Keywords: Xanthogranulomatous cholecystitis; cholecystectomy; malignancy.
Subjects: Pharmacy > MCOPS Manipal > Pharmacy Practice
Medicine > KMC Manipal > Surgery
Depositing User: KMC Manipal
Date Deposited: 13 Jun 2015 05:07
Last Modified: 13 Jun 2015 05:07
URI: http://eprints.manipal.edu/id/eprint/142967

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