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Common Procedure: Xanthogranulomatous Cholecystitis. Int Surg: September- ... macrophages in regions of destructive inflammation. Xanthogranulomatous.
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Volume 99, Issue 5 (September-October 2014)

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Article Citation: Fatih Taskesen, Zulfu Arikanoglu, Omer Uslukaya, Abdullah Oguz, Ibrahim Aliosmanoglu, Abdurrahim Dusak, Gul Turkcu, and Hekim Kuzu (2014) A Rare Finding During a Common Procedure: Xanthogranulomatous Cholecystitis. Int Surg: September-October 2014, Vol. 99, No. 5, pp. 595-599. doi: http://dx.doi.org/10.9738/INTSURG-D-13-00094.1

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HEPATOBILLARY SURGERY Current Issue Available Issues

A Rare Finding During a Common Procedure: Xanthogranulomatous Cholecystitis Fatih Taskesen1, Zulfu Arikanoglu1, Omer Uslukaya1, Abdullah Oguz1, Ibrahim Aliosmanoglu1, Abdurrahim Dusak2, Gul Turkcu3, Hekim Kuzu1

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Department of Surgery, Dicle University Hospital, Faculty of Medicine, 21280, Diyarbakir, Turkey 2 Department of Radiology, Dicle University Hospital, Faculty of Medicine, 21280, Diyarbakir, Turkey 3 Department of Pathology, Dicle University Hospital, Faculty of Medicine, 21280, Diyarbakir, Turkey

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Abstract Xanthogranulomatous cholecystitis is a rare variant of chronic cholecystitis characterized by severe proliferative fibrosis and accumulation of lipid-laden macrophages in regions of destructive inflammation. Xanthogranulomatous cholecystitis clinically and radiologically mimics early-stage gallbladder cancer, with wall thickening on computed tomography. The study included 14 xanthogranulomatous cholecystitis patients that were identified following retrospective analysis of the records of 1248 patients that underwent cholecystectomy between 2005 and 2011. Mean age of the 5 male and 9 female patients was 56.7 years. All 14 patients had gallbladder stones; 10 had a history of acute cholecystitis, 1 had cholangitis, and 2 presented with obstructive jaundice. A right-upper quadrant mass was palpable in 2 patients. All patients underwent cholecystectomy. Open surgery was planned and performed in 6 of the 14 patients, and laparoscopic cholecystectomy was planned in 8 patients, but was converted to open surgery in 1 case. In total, 1 patient developed wound infection, 1 patient had postoperative pneumonia, and 1 patient developed intraabdominal hematoma. None of the patients in the series died. Xanthogranulomatous cholecystitis is difficult to diagnose, both preoperatively and intraoperatively, and definitive diagnosis depends exclusively on pathological examination. Xanthogranulomatous cholecystitis should be a consideration in all difficult cholecystectomy cases.

Zulfu Arikanoglu Omer Uslukaya

Keywords: Gallbladder, Cholecystitis, Xanthogranulomatosis

Abdullah Oguz Ibrahim Aliosmanoglu Abdurrahim Dusak Gul Turkcu

Corresponding author: Fatih Taskesen, Assistant Professor, Dicle University School of Medicine, Department of General Surgery, 21280, Yenisehir, Diyarbakir-Turkey. Tel.: +90–412.248-8001 (4754) Fax: +90 412.248-8523; E-mail: [email protected]

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http://www.internationalsurgery.org/doi/abs/10.9738/INTSURG-D-13-00094.1

24.01.2015