Xanthogranulomatous cholecystitis: Is an initial laparoscopic approach feasible?

Park, Jae-Woo; Kim, Kee-Hwan; Kim, Say-June; Lee, Sang Kuon

doi:10.1007/s00464-017-5604-z

Cited by 24 publications

(26 citation statements)

References 21 publications

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“…The average operative times were 127 min for OC, 82 min for LC and 141 min for LOC. All these times are similar to those published by other authors, and are longer than those corresponding to patients without XGC, according to the data reported previously . The conversion rate for laparoscopic cholecystectomy in patients without XGC commonly varies between 2 and 10 per cent .…”

Section: Discussionsupporting

confidence: 90%

Xanthogranulomatous cholecystitis: A 14‐year experience

et al. 2019

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Aim: Xanthogranulomatous cholecystitis (XGC) is a rare disease. The present study was conducted to evaluate the results of both open cholecystectomy (OC) and laparoscopic cholecystectomy (LC), in patients with XGC. Patients and Methods: A retrospective study was performed including 4228 patients who underwent an OC or LC between January 2003 and November 2017. Sixty-three patients with XGC were identified, and their clinical and operative details were analysed. Results: The incidence of XGC was 1.49 per cent. The mean age of the patients was 65.8 years, and 57 per cent were male. The most common clinical presentation was acute cholecystitis (44.4 per cent). Fortyfive patients (71.4 per cent) underwent an LC, with a conversion rate of 40 per cent. The mean operative times were 127.2 min for OC, 82.2 min for LC and 141.6 min for LC to OC conversion (LOC). The mean operative time was significantly longer for OC compared with LC (P = 0.02). Fifteen patients (23.8 per cent) had some postoperative complications, of which the most frequent was incisional surgical site infection (6.34 per cent). Two patients died (3.2 per cent). The mean postoperative stay was 5.07 days for LC and 11.77 days for OC (P = 0.005). Conclusions: XGC is a rare disease associated with prolonged surgical times, high morbidity and a high LOC rate.

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Section: Discussionsupporting

confidence: 90%

Xanthogranulomatous cholecystitis: A 14‐year experience

et al. 2019

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“…To the best of our knowledge, few studies have reported outcomes of LC for XGC (summarized in Table III) (7)(8)(9)(10)(11)(12)(13)(14)(15). Our study included a relatively large number of patients that underwent LC (38 cases) compared to most other studies (range, 7-47 patients).…”

Section: Discussionmentioning

confidence: 99%

“…It was reported that, compared to open cholecystectomy, LC was associated with a lower postoperative complication rate and shorter postoperative hospital stay (4)(5)(6). However, few studies have investigated the surgical outcome of LC treatments for XGC; furthermore, the outcome has been an issue of controversy (7)(8)(9)(10)(11)(12)(13)(14)(15). For example, in patients undergoing LC for XGC, the various reported rates of converting from laparoscopic surgery to open surgery have ranged between 10 and 80%, which gave rise to the controversy.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of laparoscopic cholecystectomy for xanthogranulomatous cholecystitis

et al. 2019

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Xanthogranulomatous cholecystitis (XGC) is a rare inflammatory disease of the gallbladder with distinct histopathological characteristics. Laparoscopic cholecystectomy (LC) is currently the standard treatment for gallbladder disease. However, the outcomes of LC for XGC have not been completely investigated, due to the rarity of XGC. The present study aimed to assess the surgical outcomes of LC for XGC. Among 3,037 patients undergoing cholecystectomy between 2005 and 2017 at our institution, 58 patients (1.9%) were diagnosed with XGC based on histopathology. Of the patients, LC was performed in 38 (65.5%), and they were enrolled in the present study. The outcome of LC for XGC in the cases was assessed, and was compared with outcomes of LC for other diseases. The average operation time was 109±36 min, and average intraoperative blood loss was 58±85 ml. LC was converted to open cholecystectomy in 6 (15.8%) of the 38 cases. No operative mortality occurred. One patient developed postoperative complications greater than grade II in the Clavien-Dindo classification, and the mean postoperative hospital stay was 6.1±5.8 days. Based on previous reports and the nature of XGC itself, the outcomes reported herein of LC for XGC seemed acceptable. It should be also noted that LC for XGC exhibited a higher conversion rate compared with LC than other benign gallbladder diseases, implying that LC for XGC remains challenging.

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“…Xanthogranulomatous cholecystitis is an inflammatory disease characterized by the accumulation of lipid-laden macrophages, fibrous tissue, acute and chronic inflammatory cells. It may mimic gallbladder cancer as involvement in neighboring organs (20). It has also been reported that there is a relationship between xanthogranulomatous cholecystitis and carcinoma of the gallbladder cancer (21).…”

Section: Discussionmentioning

confidence: 99%

Is Routine Histopathological Gallbladder Examination Necessary After Cholecystectomy? Evaluation of the Results of 1,366 Cholecystectomy Specimens in Single Center

Uysal

Sezgın

Bakır

et al. 2017

Konuralp Tıp Dergisi

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Objective: It was aimed to evaluate the results of routine histopathological examination after cholecystectomy and to investigate the necessity of routine histopathologic examination after cholecystectomy. Methods: The study was designed retrospectively. One thousand three hundred sixty six patients who underwent laparoscopic and open cholecystectomy at Private Sani Konukoglu Hospital with pre-diagnosis of benign gallbladder disease between November 2011 and May 2017 were included in the study. Patients' demographic data, pathologic results, macroscopic appearance of the specimen, and cancer staging were recorded. The distribution and frequency of pathologic diagnoses and the prevalence of incidental gallbladder cancer (GBC) were evaluated. Pathologic findings were compared in terms of age groups and gender relations. Results: The number of patients included in the study was 1366. Diagnosed with chronic cholecystitis patients were 1,303 (95%), 39 (3%) with acute cholecystitis, 7 (0.5%) with gallbladder cancer, and 17 (1.5%) with other diagnoses of the patients. Statistical significance was found between the groups in terms of the mean age (p = 0.0002). Comparisons between groups in terms of cholesterolysis were statistically significant (p = 0.0003). There was a significant relationship between mucosa atrophy and gender (p = 0.001). Conclusions: The histopathological spectrum of gallbladder is quite extensive. Incidental GBC may not be detected by preoperative imaging methods. Incidental GBC are usually asymptomatic. T 2 , T 3 and T 4 GBC were also encountered in our study. All of these patients need additional operations. In the absence of routine histopathologic examination, metastatic advanced GBC may be encountered because no treatment plans could make. Thus, we do recommend routine histopathological examination.

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Xanthogranulomatous cholecystitis: Is an initial laparoscopic approach feasible?

Abstract: An initial laparoscopic approach is possible for xanthogranulomatous cholecystitis. However, it is troublesome and challenging, with significantly higher conversion and complication rates compared to standard laparoscopic cholecystectomy.

Cited by 24 publications

References 21 publications

Xanthogranulomatous cholecystitis: A 14‐year experience

Xanthogranulomatous cholecystitis: A 14‐year experience

Outcomes of laparoscopic cholecystectomy for xanthogranulomatous cholecystitis

Is Routine Histopathological Gallbladder Examination Necessary After Cholecystectomy? Evaluation of the Results of 1,366 Cholecystectomy Specimens in Single Center

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