黄色肉芽肿性胆囊炎的诊疗特点

目的探讨黄色肉芽肿性胆囊炎(xanthogranulomatous cholecystitis,XGC)的诊断与手术治疗特点。方法回顾性分析13例经病理确诊的XGC病人的临床资料。术前B超检查13例,CT检查5例,MRI检查3例,ERCP检查1例,术前均误诊。结果11例行术中冰冻切片病理检查,确诊9例。9例行胆囊切除术,1例行胆囊切除加胆总管探查T管引流术,1例行胆囊大部切除加十二指肠瘘修补术,2例行胆囊切除加胆囊床部肝组织切除。均治愈,无死亡病例。结论XGC是一种少见的特殊类型的慢性胆囊炎,术前诊断困难,确诊依赖病理检查,开腹胆囊切除是基本手术方式。

Diagnosis and Treatment for Xanthogranulomatous Cholecystitis

Objective To study the characteristics of diagnosis and surgery for xanthogranulomatous cholecystitis(XGC).Method The clinical data of 13 patients of XGC was analyzed.All patients were misdiagnosed though 13 were examined by B-ultrasound,5 by CT,3 by MRI,and 1 by ERCP.Result 9 got final diagnosis in 11 cases who received frozen pathological exam during operation.Complete cholecystectomy was executed in 9 cases,in addition,exploration of common bile duct and T-tube drainage was done in 1 case,bile bladder bed liver wedge resection was done in 2 cases.Greater partial cholecystectomy and duodenal fistula repair was done in 1 case.All patients cured without perioperative death.Conclusion XGC is a rare and special type of chronic cholecystitis.It is difficult to be diagnosed before operation.Definite diagnosis depends on pathological examination.The basic method of treatment is open cholecystectomy.