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Vol. 29, No. 3, 2012
Issue release date: August 2012
Section title: Original Paper
Dig Surg 2012;29:187–193
(DOI:10.1159/000336985)

Xanthogranulomatous Cholecystitis: Catching the Culprit – Clinical and Imaging Analysis

Jain S. · Saluja S.S. · Sharma A.K. · Sant H. · Mishra P.K.
Departments of aGastrointestinal Surgery and bRadiology, GB Pant Hospital, New Delhi, India

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 11/1/2011
Accepted: 1/28/2012
Published online: 6/2/2012

Number of Print Pages: 7
Number of Figures: 3
Number of Tables: 2

ISSN: 0253-4886 (Print)
eISSN: 1421-9883 (Online)

For additional information: http://www.karger.com/DSU

Abstract

Background: Radiological and intraoperative findings of xanthogranulomatous cholecystitis (XGC) mimic carcinoma gallbladder (CaGB) leading to extended surgical resections and increased morbidity. We reviewed the clinical and CECT findings of histopathologically proven XGC and compared them with those of CaGB. Methods: The clinical and CECT findings from 22 patients with XGC were compared with 15 patients with CaGB manifesting as diffuse wall thickening. Results: GB wall thickness was similar in both groups (XGC 12.4 ± 3 mm, CaGB 13.9 ± 6.5 mm; p = 0.61). Intramural hypoattenuating nodules occupying >60% of the GB wall were suggestive of XGC, while the absence of nodules suggested CaGB (p = 0.017). The mucosal lining was intact and enhancing in XGC (20/22) and disrupted in CaGB (10/15; p = 0.001). Among adjacent organ infiltration, bile duct invasion resulting in obstruction was a significant finding in patients with CaGB (p = 0.04). Among XGC patients, 11 patients underwent radical cholecystectomy, 10 had open cholecystectomy and frozen section and 1 underwent bypass. Conclusions: Though there is an overlap between XGC and CaGB, the presence of intramural hypoattenuating nodules occupying >60% of the diffusely thickened GB wall with intact mucosal line and the absence of obstructive features suggest XGC. In the presence of such imaging features, frozen biopsy should be done before proceeding with mutilating radical surgery.


  

Author Contacts

Assoc. Prof. Sundeep Singh Saluja
Department of Gastrointestinal Surgery
GB Pant Hospital and Maulana Azad Medical College, 2, Jawaharlal Nehru Marg
New Delhi 110002 (India)
Tel. +91 971 859 9259, E-Mail sundeepsaluja@yahoo.co.in

  

Article Information

Received: November 1, 2011
Accepted after revision: January 28, 2012
Published online: June 2, 2012
Number of Print Pages : 7
Number of Figures : 3, Number of Tables : 2, Number of References : 18

  

Publication Details

Digestive Surgery

Vol. 29, No. 3, Year 2012 (Cover Date: August 2012)

Journal Editor: Tilanus H.W. (Rotterdam), Wijnhoven B.P.L. (Rotterdam), Gouma D.J. (Amsterdam), van Lanschot J.J.B. (Rotterdam)
ISSN: 0253-4886 (Print), eISSN: 1421-9883 (Online)

For additional information: http://www.karger.com/DSU


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 11/1/2011
Accepted: 1/28/2012
Published online: 6/2/2012

Number of Print Pages: 7
Number of Figures: 3
Number of Tables: 2

ISSN: 0253-4886 (Print)
eISSN: 1421-9883 (Online)

For additional information: http://www.karger.com/DSU


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