黄色肉芽肿性胆囊炎的诊疗特点

Diagnosis and Treatment for Xanthogranulomatous Cholecystitis

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。

Objective To study the characteristics of diagnosis and surgery for xanthogranulomatous cho- lecystitis（XGC）. Method The clinical data of 13 patients of XGC was analyzed. All patients were misdiag- nosed 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.