Xanthogranulomatous cholecystitis: A rare condition with variable presentations

Abstract

Aim: Patients suffering from xanthogranulomatous cholecystitis have variable clinical presentations. The present study aims to evaluate the clinical presentations of the disease and the various surgical treatment strategies in the management of patients suffering from xanthogranulomatous cholecystitis. Methods: This is a retrospective study in a university teaching hospital and a tertiary referral centre. The histopathological records of 5016 resected gallbladder specimens from January 1991 to June 2007 were reviewed and case notes of patients with a diagnosis of xanthogranulomatous cholecystitis were retrieved. Results: Eighty‐six patients with xanthogranulomatous cholecystitis were identified. The spectrum of presentation was variable and a high proportion of patients had complicated pathology. Patients commonly presented with obstructive jaundice or acute cholecystitis. The proportion of patients with diabetes mellitus who presented with acute cholecystitis was higher than the local prevalence in this study. Conversion rate in laparoscopic cholecystectomy was also higher for patients with xanthogranulomatous cholecystitis. Conclusion: The clinical presentation of xanthogranulomatous cholecystitis is variable. The disease commonly presents as obstructive jaundice or acute cholecystitis but it may mimic carcinoma of the gallbladder. The disease carries a higher rate of conversion if laparoscopic cholecystectomy was attempted.

Xanthogranulomatous Cholecystitis: Analysis of 108 Patients

“…However, in a review by Guzman-Valdivia, predominantly male patients were reported [4]. In this study, the average age at presentation was 62.3 years, which is similar to other studies [8,11,12].…”

“…The inflammatory phenomenon in XGC is hypothesized to be effective through the metaplasia-dysplasia-neoplasia sequence [24,25]. Moreover, in 30 % of gallbladder carcinomas, focal xanthogranulomatous changes have been identified in the gallbladder wall that demonstrates neoplastic invasion [26,27]; therefore, frozen section is recommended [4,8,11,12]. Frozen section was performed in 18 patients, and carcinoma was diagnosed in two cases who received radical cholecystectomy.…”

Xanthogranulomatous cholecystitis: experience in 100 cases

“…However, XGC is often misdiagnosed as GBCa, leading to unnecessary radical surgical excision. The incidence of XGC was approximately 0.2% in our study, the average age was 55.6 years, which was like that found in other studies (7,12), highlighting that the onset age of XGC was relatively late. Although no clinical symptoms were specific to XGC (1), patients present typical features of chronic or acute cholecystitis, including chronic or acute RUQ pain, jaundice, anorexia, abdominal distension, hyperpyrexia, nausea and vomiting, and RUQ mass, with RUQ pain being the most commonly reported complaint (13).…”