Is xanthogranulomatous cholecystitis the most difficult for laparoscopic cholecystectomy?
Kim, JH; Jeong, IH; Yoo, BM; Kim, MW; Kim, WH
Hepato-gastroenterology, 56(91-92):597-601, 2009
BACKGROUND/AIMS: Xanthogranulomatous cholecystitis (XGC) is a rare disease of the gallbladder, showing high conversion rate and complications. However, it has been reported as collected data or as a case review. Therefore, we compared surgical outcomes of laparoscopic cholecystectomy (LC) in patients who were diagnosed with XGC with that of other cholecystitis.
METHODOLOGY: From November 2001 to March 2008, 3209 cholecystectomies were performed at Ajou University Medical Center. Twenty-three patients (0.7%) were histopathologically diagnosed with XGC. Of 23 patients, we retrospectively analyzed the data of 15 patients who underwent initial laparoscopic approach for XGC and compared the data with those of severe acute and non-severe cholecystitis (SAC and NSC).
RESULTS: The conversion rate was 40% (6/15) and mean operative time was 101.6+/-47.1 min. In the XGC group, conversion rate was significantly higher than in the other cholecystitis groups, even more than that for severe acute cholecystitis (SAC) (P<0.05). In addition, the rate of coexistence of gallbladder cancer (13.3%) was significantly higher in the XGC group than in the SAC group (P<0.05). Whereas, there were no statistical differences in the operative time and postoperative stay between XGC and SAC. Postoperative complications were present in 2 patients, including colonic fistula and major bile duct injury, however it was not significantly different between the three groups (P>0.05).
CONCLUSIONS: XGC is association with a high conversion rate and a high coexistence of gallbladder cancer, compared even with SAC. Therefore, a careful preoperative evaluation for differentiation between XGC and gallbladder cancer is needed. First of all, proper intraoperative decision making such as whether the frozen-section biopsy and/or conversion to open cholecystectomy should be performed is important.
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.
Total Visit :2,043,752
Total Download :865,550
Today View :36
Ajou University Medical Information & Media Center 164 Worldcup-ro Yeongtong-gu Suwon 16499 Korea / TEL : 031-219-5312 / FAX : 031-219-5314 Copyright (c) Ajou University Medical Information & Media Center All Rights Reserved. AJOU Open Repository는 국립중앙도서관 OAK 보급사업으로 구축되었습니다.