黄色肉芽肿性胆囊炎的临床诊断及治疗分析

目的探讨黄色肉芽肿性胆囊炎的诊断与治疗,提高对该疾病的认识及诊治水平。方法对2004年9月2009年10月确诊为黄色肉芽肿性胆囊炎的15例患者资料进行回顾性分析。结果确诊为黄色肉芽肿性胆囊炎3例,慢性胆囊炎8例,胆囊癌4例。10例行胆囊切除术,2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,1例行胆囊大部切除加胃瘘修补术,1例行胆囊切除加胆囊床部肝组织切除。术后并发胆瘘1例,切口感染2例。无死亡病例。结论黄色肉芽肿性胆囊炎术前难诊断,术中冷冻切片检查和术后病理检查是诊断的关键,手术切除胆囊是主要治疗方法。

Analysis of the Clinical diagnosis and Treatment of Xanthogranulomatous Cholecystitis

Objective To evaluate the clinical diagnosis and treatment of xanthogranulomatous cholecystitis. Methods The clinical data of 15patients with xanthogranulomatous cholecystitis treated in our hospital from September 2004to October 2009were retrospectively analyzed.Results All of 15patients were diagnosed as xanthogranulo-matous cholecystitis through postoperative pathologic examination,including 3were diagnosed as xanthogranuloma-tous cholecystitis,8were diagnosed as chronic cholecystitis,and 4were diagnosed as gallbladder carcinoma.All pa-tients underwent the operations including cholecystectomy in 10,cholecystectomy plus choledochojejunostomy and T tube drainage in 2,gallbladder subtotal plus duodenal fistula in 1,gallbladder subtotal resection of gastric fistula in 1,and cholecystectomy plus the department of the gallbladder bed resection of liver tissue in 1.The postoperative complications included biliary fistula in 1case and wound infection in 2cases;no deaths were found.Conclusion Xanthogranulomatous cholecystitis is difficult to diagnose before the operations.The keys of the diagnosis are the intraoperative frozen section examination and postoperative pathologic examination.Cholecystectomy is the main operation for xanthogranulomatous cholecystitis.