黄色肉芽肿性胆囊炎的诊治探讨

THE PROBE OF DIAGNOSIS AND TREATMENT FOR XANTHOGRANULOMATOUS CHOLECYSTITIS

目的探讨黄色肉芽肿性胆囊炎(XGC)的诊断与治疗。方法回顾17例XGC的临床资料。结果术前B超检查17例,反复CT检查6例,均未能明确诊断,全部病例均术后病理确诊。手术方式:12例行胆囊切除术,2例行胆囊大部切除术,3例行胆囊床肝脏楔形切除术和肝十二指肠韧带淋巴结清扫术,17例均治俞。结论XGC是一种少见的特殊型的慢性胆囊炎,影像学检查易与胆囊癌混淆,确诊依赖病理检查,手术切除是早期诊断治疗的的最佳方法。术中冰冻切片病理检查,避免手术盲目扩大化。

Objective To probe into the diagnosis and treatment for XGC. Method To review the clinical data of 17 patients with XGC. Results 17 patients were examine with B-urtal sound in which 6 cares were re-examin in with CT. All patients were misdiagnosis before operation ,while all were definite diagnosed through post-operative pathological examination. Compete cholecysteetomy was executed in 12 cases,Greaster partial cholecystecomy ware executed in 2 cases. In addition to eholecystectomy,3 cases were executed with partial eholecystecomy ware executed in 2 cases. In addition to eholecystectomy ,3 cases were executed with partial liver wedge resection beneath gallbladder bed and lymph node clearing in liver duodenum ligament, 17 cases was cured. Conclusion XGC is a rare and special type chronic eholecystitis, tt is liable to be confused with cholecyst carcinoma in reflection photograph test. Definite diagnosis depends on pathological examination. The optimal means of early diagnosis and treatment is cholecystectomy operation in which intra operative freezing section is critical. Randomly magnified operation should be avoided.