title: A rare finding during a common procedure: xanthogranulomatous cholecystitis.
abstract: Xanthogranulomatous cholecystitis is a rare variant of chronic cholecystitis characterized by severe proliferative fibrosis and accumulation of lipid-laden macrophages in regions of destructive inflammation. Xanthogranulomatous cholecystitis clinically and radiologically mimics early-stage gallbladder cancer, with wall thickening on computed tomography. The study included 14 xanthogranulomatous cholecystitis patients that were identified following retrospective analysis of the records of 1248 patients that underwent cholecystectomy between 2005 and 2011. Mean age of the 5 male and 9 female patients was 56.7 years. All 14 patients had gallbladder stones; 10 had a history of acute cholecystitis, 1 had cholangitis, and 2 presented with obstructive jaundice. A right-upper quadrant mass was palpable in 2 patients. All patients underwent cholecystectomy. Open surgery was planned and performed in 6 of the 14 patients, and laparoscopic cholecystectomy was planned in 8 patients, but was converted to open surgery in 1 case. In total, 1 patient developed wound infection, 1 patient had postoperative pneumonia, and 1 patient developed intraabdominal hematoma. None of the patients in the series died. Xanthogranulomatous cholecystitis is difficult to diagnose, both preoperatively and intraoperatively, and definitive diagnosis depends exclusively on pathological examination. Xanthogranulomatous cholecystitis should be a consideration in all difficult cholecystectomy cases.
authors.affiliation: 1 Department of Surgery, Dicle University Hospital, Faculty of Medicine, 21280, Diyarbakir, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Taskesen
authors.forename: Zulfu
authors.initials: Z
authors.lastname: Arikanoglu
authors.forename: Omer
authors.initials: O
authors.lastname: Uslukaya
authors.forename: Abdullah
authors.initials: A
authors.lastname: Oguz
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Aliosmanoglu
authors.forename: Abdurrahim
authors.initials: A
authors.lastname: Dusak
authors.forename: Gul
authors.initials: G
authors.lastname: Turkcu
authors.forename: Hekim
authors.initials: H
authors.lastname: Kuzu
mesh_terms: D000328:Adult; D000368:Aged; D002763:Cholecystectomy; D002764:Cholecystitis / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006099:Granuloma / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014973:Xanthomatosis / Q000175:diagnosis / Q000601:surgery*
keywords: Cholecystitis; Gallbladder; Xanthogranulomatosis