Clinical Analysis Of 16 Cases Of Xanthogranulomatous Cholecystitis

Objective: To investigate the clinical diagnosis and treatment of XGC,and provide a basis for clinical diagnosis and treatment of XGC.Methods: A retrospective analysis of 16 cases of pathological diagnosis of XGC in our hospital from December 2009 to December 2017,collecting related materials like clinical signs and symptoms,laboratory examination,imaging examination,surgery and pathology,to analyze the clinical features of XGC.And in the most confusing part of the disease to analysis the difference with gallbladder cancer,and finally summarized the clinical features of XGC.Results: According to the clinical data of 16 patients with XGC collected preoperative,including clinical symptoms,signs,laboratory examination,imaging examination,surgical records.The clinical symptoms and signs of the patients,such as right upper quadrant pain,jaundice,fever,are not clinically specific,similar to general acute and chronic cholecystitis and gallbladder cancer.Laboratory tests such as white blood cell count,serum total bilirubin,AST and ALT are also non-specific and can be elevated in many diseases.Serum tumor markers(CEA and CA19-9)were elevated in both XGC and gallbladder cancer cases,and the difference was not statistically significant.In imaging findings,submucosal hypoattenuated nodules and continuous mucosal lines are considered to be characteristic features of XGC,and the thickening of the gallbladder wall can also be used to distinguish the two.Eventually,10 cases diagnosed as chronic cholecystitis,1 case diagnosed as acute cholecystitis,1 case as gallbladder stones with gallbladder duodenal fistula,1 case as Mirizzi syndrome and 3 cases as gallbladder carcinoma.In the operation.The pathological diagnosis of 16 patients were XGC postoperative.Among the 16 patients,2 cases underwent laparoscopic cholecystectomy,3 cases underwent laparoscopic conversion to open cholecystectomy,and 6 cases underwent cholecystectomy.3 cases underwent cholecystectomy and common bile duct exploration with T-tube drainage,1 case of cholecystectomy plus duodenal incision and duodenal hernia repair,and 1 case of cholecystectomy and partial liver resection of the gallbladder bed.The patients in this group recovered well after surgery and were curedwithout death.Conclusion: Xanthogranulomatous cholecystitis is a rare and special type of chronic cholecystitis.Preoperative manifestations include gallstones,acute and chronic cholecystitis and gallbladder cancer.It is difficult to distinguish from GBC preoperatively.It is currently believed that XGC may be associated with GBC.Therefore,once found,active surgery should be performed.Intraoperative frozen section and postoperative pathological examination are indispensable,and the diagnosis depends on pathology.If we confirmed the diagnosis of XGC during surgery,cholecystectomy should be performed,and the resection should not be blindly enlarged,causing unnecessary damage.