Presentation and surgical management of xanthogranulomatous cholecystitis

Frountzas, Maximos; Schizas, Dimitrios; Liatsou, Εfstathia; Economopoulos, Konstantinos P.; Nikolaou, Charalampos; Αποστόλου, Κωνσταντίνος; Toutouzas, Konstantinos G.; Felekouras, Evangelos

doi:10.1016/j.hbpd.2021.01.002

Cited by 20 publications

(32 citation statements)

References 57 publications

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“…Xanthogranulomatous cholecystitis is a rare, uncommon variant of chronic cholecystitis. The reported incidence varies from 0.3 to 1.9% in western countries, but increases up to 9% India [32,33]. In our study, chronic cholecystitis was the most common pathology (41.1%), and the rate of xanthogranulomatous cholecystitis was 23.2%, higher than that reported in the literature.…”

Section: Discussioncontrasting

confidence: 57%

Percutaneous cholecystostomy results of 136 acute cholecystitis patients: A retrospective cohort study

Yeşiltaş¹,

Karakaş²,

Aribal³

et al. 2021

Journal of Surgery and Medicine

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Background/Aim: Percutaneous cholecystostomy (PC) is an alternative procedure to surgery in selected patients with acute cholecystitis (AC). This study aimed to review the clinical and surgical results of patients who underwent percutaneous cholecystostomy. Methods: The records of patients who underwent PC for AC were evaluated for age, gender, comorbidities, survey, catheterization timing, complications, control, removal timing, operation type, interval time, pathology, C-reactive protein (CRP) level and white blood cell count (WBC), ultrasonography (USG) and computed tomography (CT) results. Results: One hundred and thirty-six AC patients who underwent PC were included in the study. The median age was 73 (32-96) years and 57.3% of the patients were male. Out of the 136, 106 (78%) had an American Society of Anesthesiologists (ASA) classification score of 3 or 4. The median Charlson's comorbidity index (CCI) score was 5 (0-13). The median timing of catheterization was 23 (20-144) hours and length of hospital stay (LOS) was 3 (1-25) days. Dislocation was the most common complication of PC, and 7.4% (n=10) had recurrent AC. The median time until tube removal was 26.5 (1-238) days. Among all, 41.2% (n=56) of the patients underwent interval cholecystectomy, which equates to 76.8% of the those performed laparoscopically. The median time until the operation was 100 (1-264) days. Chronic cholecystitis was the most common pathology of cholecystectomy after PC. Bacterial bile cultures were analyzed in 36 of the patients and showed positive results in 66.7%, with no overall effect on the outcome. Nine patients (6.6%) died. Conclusion:The importance of PC in AC increased with the Covid19 pandemic. PC was performed especially for old patients with ASA ≥3, and CCI ≥5 due to lower complication and recurrence rates. PC could be the final treatment for selected AC patients. Interval cholecystectomies performed after 8 weeks had a shorter LOS and a lower rate of complication.

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Section: Discussioncontrasting

confidence: 57%

Percutaneous cholecystostomy results of 136 acute cholecystitis patients: A retrospective cohort study

Yeşiltaş¹,

Karakaş²,

Aribal³

et al. 2021

Journal of Surgery and Medicine

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“…XGC still not proven as premalignant lesion [4,5] . Although they can present together but the pathogenetic link between them isn't proven yet.…”

Section: Discussionmentioning

confidence: 99%

“…Post-operative complications like any other abdominal surgery and differ in incidence and severity from laparoscopic and open surgery. Wound Infections, bile fistula, cholangitis, and residual choledocholithiasis [4] . Rate of conversion to open cholecystectomy is higher in XGC than other forms of cholecystitis [1] .…”

Section: Discussionmentioning

confidence: 99%

“…Incidence of XCG reported between 1.3%-5.2% of resected Gallbladder specimens [1][2][3] . The most common chief complaints of the patient are Abdominal pain, others symptoms include Vomiting, nausea, changes in bowel habits [1,4] obstructive jaundice and its sequels can occur in about 20-25 % [2] weight loss and palpable mass also reported [2,4,5] . Ultrasound abdomen is considered first modality of radiological investigation and can showed thickness of gallbladder wall, intramural nodule, gallstone, or pericholecystic fluid [2,5,6] .…”

Section: Introductionmentioning

confidence: 99%

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Laparoscopic Management of Unusual Presentation and Age of Xanthogranulomatous Cholecystitis, Case Report and Literature Review

Alsuwaydani

Alfehaid

2021

ijirms

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Background: Xanthogranulomatous cholecystitis XGC is a rare variant of Cholecystitis characterized by extensive inflammation and Fibrosis and associated with more complicated presentation like invading other organs and fistula formation. it could mimic Underlying malignancy like Gallbladder Cancer GBC. Challenges started by difficulty of diagnosis pre operatively due to multi factors include less threshold of diagnosis, which can lead to over treatment if GBC suspected. Gallstones plays major role in pathogenesis of most variant of Cholecystitis and can be trigger for GBC. Case presentation: we report 2 cases with different pre-operative course, both cases managed with laparoscopic cholecystectomy, and Histopathology showed Xanthogranulomatous cholecystitis XGC. Discussion: recent cases reported for XCG usually occurs in 5th and 6th decades and presented with multiple presentation and could be missed diagnosis, laboratory and radiological investigations can offer a limited diagnosis if not interpreted by expertise. Management can vary from simple laparoscopic cholecystectomy -as in our cases – and can extend to major en block resection.

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“…Así también, la prevalencia de la CXG depende de la ubicación geográfica, oscilando entre 1.3-1.9 % (Europa, EE.UU. y Japón [15,17] ), 2.5-3.2 % (Latinoamérica) [12,18,19] y hasta 9 % (India) [7,11,16] , de todas las colecistectomías; con solo un reporte en nuestro medio [12] . Y se observa principalmente entre los 60-70 años [20,21] con reportes de predominio en hombres [7,12] , en mujeres [10,17,14,21] y otros sin diferencia [11,20] .…”

Section: Introductionunclassified

Absceso hepático por colecistitis xantogranulomatosa y ademiomatosis vesicular: reporte de un caso.

Vera-Portilla

Ruiz

Portilla³

et al. 2021

Acta Med Peru

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La colecistitis xantogranulomatosa (CXG) y la Adenomiomatosis (AV) son infrecuentes, con escasos reportes en nuestro medio. La diferenciación preoperatoria e intraoperatoria es difícil, porque presenta características radiológicas y macroscópicas, similares al cáncer. Frecuentemente se presenta como una colecistitis aguda. Y el diagnóstico se establece por la presencia de fibrosis, histiocitos espumosos, y de los senos de Rokitansky-Aschoff, respectivamente. Presentamos el caso de una mujer que acudió por dolor abdominal, náuseas y vómitos. La tomografía reveló una colección hepática subcapsular. Se interviene quirúrgicamente y se evidencia absceso hepático bloqueado por epiplón, con múltiples adherencias; y vesícula de paredes engrosadas perforada en bacinete. Paciente recibe antibióticoterapia, cursa con buena evolución, y la histopatología concluye una CXG y AV. La CXG y la AV son enfermedades raras, asociadas a colelitiasis. En nuestro caso, su asociación, y su complicación con absceso hepático, hacen que sea particularmente excepcional. Requiriendo ambas, cirugía e histopatología para confirmarlas.

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Presentation and surgical management of xanthogranulomatous cholecystitis

Cited by 20 publications

References 57 publications

Percutaneous cholecystostomy results of 136 acute cholecystitis patients: A retrospective cohort study

Percutaneous cholecystostomy results of 136 acute cholecystitis patients: A retrospective cohort study

Laparoscopic Management of Unusual Presentation and Age of Xanthogranulomatous Cholecystitis, Case Report and Literature Review

Absceso hepático por colecistitis xantogranulomatosa y ademiomatosis vesicular: reporte de un caso.

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