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的 (XGC)的诊断与治疗。方法 回顾 10例XGC的临床资料。结果 B超检查 10例 ,CT检查 3例 ,术前全部误诊 ,术后病检确诊 10例。 9例行胆囊切除 ,1例行胆囊大部切除 ,其中 2例行胆囊床肝脏楔形切除并肝十二指肠韧带淋巴结清扫 ,1例加胃大部切除。 9例治愈 ,1例死亡。结论 XGC是一种少见特殊类型的慢性胆囊炎 ,影像学检查易与胆囊癌混淆 ,确诊依赖病理检查 ,手术切除胆囊是早期诊断治疗的最佳途径。术中冰冻切片病检 。

Objective To probe into the diagnosis and treatments for XGC.Method To review the clinical data of 10 patients with XGC.Results Ten patients were examin with B-Urtral sound in which 3 patients were re-examin with CT.All patients were misdiagnosed before operation,while all were definite diagnosed through post-operative pathological examination.Complete cholecystectomy was executed in 9 cases.Greater partial cholecystectomy was executed in 1 case.In addition to cholecystectomy,2 cases were executed with partial liver wedge resection beneath gallbladder bed and lymph node clearing in liver duodenum ligament,1 case was executed with greater partial gastrectomy.9 cases were cured,and 1 case died.Conclusions XGC is a rare and special type chronic cholecystitis.It is liable to be confused with cholecyst carcinoma in reflection photograph test.Definite diagnosis depends on pathologici 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.