Xantogranulomatous cholecystitis

Abstract

Background: xantogranulomatous cholecystitis is an inflammatory disease characterized by the des- truction of the gall bladder wall, with a prevalence between 0.7 and 13.2 % of the cholecystectomies.
Objectives: to analyze the incidence, form of presentation, and results of the treatment of this patho- logy in a HPB center of Buenos Aires.
Setting: Department of Surgery, HIGA Dr Cosme Argerich.
Design: retrospective.
Population: all the cholecystectomies performed in the Surgery Department of the HIGA Argerich.
Method: we analyzed the anatomopathological pieces of the cholecystectomies performed in the Dr Cosme Argerich Hospital Department of Surgery. Patients were divided into 2 groups according to the presentation form, A) incidental and B) pseudotumoral. We analyzed postoperative complications, length of hospital stay, and mortality.
Results: 815 laparoscopic cholecystectomies were performed, of which 32 cases where xantogranulomatous cholecystitis (3.9%). Eighteen where men and 14 women. The mean age was 40.6 years.
Abdominal sonography was performed and in the pseudotumoral presentation an abdominal TC was added. Twenty seven where incidental forms, and 5 pseudotumoral forms. The mean operatory time was 114 minutes, and there were no conversions to open surgery. Two intraoperative bile leaks were resolved in the seudotumoral form, and one bile leak and two bleeding pseudoaneurism of the hepatic artery where reoperated in the incidental form group. Hospital mean length of stay was of 2.6 days
Conclusion: xantogranulomatous cholecystitis can be presented as an usual inflammatory disease, o as a pseudotumor. Imaging is essential for differential diagnosis.