Ksantogranülomatöz kolesistitin cerrahi üzerine etkisi

Year 2021, Volume: 46 Issue: 4, 1351 - 1359, 30.12.2021

Merih Altıok , Feyzi Kurt

https://doi.org/10.17826/cumj.976851

Cited By: 1

Abstract

Amaç:. Bu çalışmada biliyer staza neden olan patolojilerin ksantogranülomatöz kolesistit (XGC) ile birlikte görülme sıklığı ve konversiyon kolesistektomiye etkisinin değerlendirilmesi amaçlanmıştır.
Gereç ve Yöntem: Bu retrospektif çalışmada Ocak 2010-Haziran 2020 tarihleri arasında Seyhan Devlet Hastanesi'nde kolesistektomi yapılan 11840 hastanın tıbbi kayıtları incelendi. Tıbbi kayıtlar incelendikten sonra patolojik olarak XGC tanısı alan hastalar çalışmaya dahil edildi.
Bulgular: Son on yılda kolesistektomi yapılan toplam 11840 hastanın 40'ına (%0.33) XGC tanısı kondu. Olguların yaş ortalaması 58 (34-88) idi. 40 hastanın 26'sında (%65) ameliyat laparoskopik olarak tamamlandı. Bunların 5'ine (%12,5) açık cerrahi uygulandı. Dokuz (%22.5) hastada laparoskopik kolesistektomiden açık cerrahiye geçildi. Tüm kolesistektomi olgularında konversiyon kolesistektomi(KK) oranı 412/11840 (%3.4) idi. Safra yolları ile ilgili tanı ve tedavi amaçlı 13 (%32.5) hastaya endoskopik retrograd kolanjiyopankreatografi (ERCP) yapıldı. Histopatolojik incelemede safra kesesi duvar kalınlığı ortalama 8,0 milimetre (± 3,87) olarak bulundu. 38 (%95) hastada duvar kalınlığında 4 milimetre veya daha fazla artış vardı. Safra stazına neden olan patolojinin alt grup analizinde ve acil kolesistektomi yapılan hastalarda KK oranı yüksek bulundu.
Sonuç: Bu çalışma ışığında XGC hastalarında safra stazına neden olan patolojilerin diğer kolesistit hastalarına göre daha sık görülmesi bu patolojilerin XGC etiyolojisi ile ilişkili olabileceğini düşündürmektedir.

Keywords

Konversiyon kolesistektomi, ksantogranülomatöz kolesistit, laparoskopi, safra kesesi

Effect of xanthogranulomatous cholecystitis on surgery

Abstract

Purpose: The aim of this study is to evaluate the incidence of pathologies causing biliary stasis together with xanthogranulomatous cholecystitis (XGC) and its effect on conversion to open cholecystectomy.
Materials and Methods: This retrospective study reviewed the medical records of 11840 patients who underwent cholecystectomy at Seyhan State Hospital between January 2010 and June 2020. After examining the medical records, 40 (0.33%) of 11840 cholecystectomy cases were diagnosed as XGC pathologically.
Results: In the last decade, 40 (0.33%) patients out of a total of 11840 patients who underwent cholecystectomy were diagnosed with XGC. The mean age of the cases was 58 (34-88). In 26 (65%) of 40 patients, surgery was completed laparoscopically. Open surgery was performed in 5 (12.5%) of them. Nine (22.5%) patients were converted from laparoscopic cholecystectomy to open surgery. In all cholecystectomy cases, the conversion cholecystectomy(CC) rate was 412/11840 (3.4%). Endoscopic retrograde cholangiopancreatography(ERCP) was performed in 13 (32.5%) patients for diagnosis and therapeutic purposes related to bile ducts. The gallbladder wall's average thickness was found to be 8.0 millimeters (± 3.87) on histopathological examination. 38 (95%) patients had an increase in gall bladder wall thickness of 4 millimeters or more. CC rate was found to be high in the subgroup analysis of pathology causing bile stasis and in patients who underwent emergency cholecystectomy.
Conclusion: This study demonstrates that the pathologies causing bile stasis are observed more frequently in XGC patients than other cholecystitis patients, suggesting that these pathologies may be associated with XGC.

Keywords

Conversion cholecystectomy, gallbladder, laparoscopy, xanthogranulomatous cholecystitis

References

• 1. Jessurun J, Albores-Saavedra J. Gallbladder and extrahepatic biliary ducts. In: Damjanov I, Linder J (eds) Anderson's pathology. 2006;p:1859
• 2. Goodman ZD, Ishak KG. Xanthogranulomatous cholecystitis. Am J Surg Pathol. 1981;5:653–59
• 3. Guzman-Valdivia G. Xanthogranulomatous cholecystitis: 15 years experience. World J Surg. 2004;28:254–57
• 4. Park JW, Kim KH, Kim SJ, Lee SK. Xanthogranulomatous cholecystitis: Is an initial laparoscopic approach feasible? Surg Endosc. 2017;31:5289-94.
• 5. Guzman-Valdivia G. Xanthogranulomatous cholecystitis in laparoscopic surgery. J Gastrointest Surg. 2005;9:494–7
• 6. Levy AD, Murakata LA, Abbott RM, Rohrmann CA. Jr From the archives of the AFIP. Benign tumors and tumorlike lesions of the gallbladder and extrahepatic bile ducts: radiologic-pathologic correlation. Armed Forces Institute of Pathology. Radiographics. 2002;22:387–413
• 7. Yang T, Zhang BH, Zhang J, Zhang YJ, Jiang XQ, Wu MC. Surgical treatment of xanthogranulomatous cholecystitis, experience in 33 cases. Hepatobiliary Pancreat Dis Int. 2007;6:504–8.
• 8. Wang M, Zhang T, Zang L, Lu A, Mao Z, Li J, et al. Surgical treatment for xanthogranulomatous cholecystitis: a report of 74 cases. Surg Laparosc Endosc Percutan Tech. 2009;19:231–3.
• 9. Sharma D, Babu R, Sood G, Kapoor G, Solanki RS, Thomas S. Xanthogranulomatous cholecystitis masquerading as malignancy with liver metastasis. ANZ J Surg. 2009;79:946–7.
• 10. Qasaimeh GR, Matalqah I, Bakkar S, Al Omari A, Qasaimeh M. Xanthogranulomatous cholecystitis in the laparoscopic era is still a challenging disease. J Gastrointest Surg. 2015 Jun;19(6):1036-42.
• 11. Krishna RP, Kumar A, Singh RK, Sikora S, Saxena R, Kapoor VK. Xanthogranulomatous inflammatory strictures of extrahepatic biliary tract: presentation and surgical management. J Gastrointest Surg. 2008 May;12(5):836-41.
• 12. Kwon AH, Matsui Y, Uemura Y. Surgical procedures and histopathologic findings for patients with xanthogranulomatous cholecystitis. J Am Coll Surg. 2004;199:204–10
• 13. Duber C, Storkel S, Wagner PK, Muller J. Xanthogranulomatous cholecystitis mimicking carcinoma of the gallbladder: CT findings. J Comput Assist Tomogr. 1984; 8(6):1195–8.
• 14. Christensen AH, Ishak KG. Benign tumors and pseudotumors of the gallbladder. Report of 180 cases. Arch pathol. 1970;5:423–32.
• 15. Parra JA, Acinas O, Bueno J, Guezmes A, Fernandez MA, Farin as MC. Xanthogranulomatous cholecystitis: clinical, sonographic, and CT findings in 26 patients. AJR. 2000;174:979–83
• 16. Goshima S, Chang S, Wang JH, Kanematsu M, Bae KT, Federle MP. Xanthogranulomatous cholecystitis: diagnostic performance of CT to differentiate from gallbladder cancer. Eur J Radiol. 2010;74:79–83
• 17. Saritas AG, Gul MO, Teke Z, Ulku A, Rencuzogullari A, Aydin I, et al. Xanthogranulomatous cholecystitis: a rare gallbladder pathology from a single-center perspective. Ann Surg Treat Res. 2020;99:230-37. doi:10.4174/astr.2020.99.4.230
• 18. Yucel O, Uzun MA, Tilki M, Alkan S, Kilicoglu ZG, Goret CC, et al. Xanthogranulomatous Cholecystitis: Analysis of 108 Patients. Indian J Surg. 2017;79:510-14
• 19. Yildirim M, Oztekin O, Akdamar F, Yakan S, Postaci H. Xanthogranulomatous cholecystitis remains a challenge in medical practice: experience in 24 cases. Radiol Oncol. 2009;43:76–83
• 20. Srinivas GN, Sinha S, Ryley N, Houghton PW. Perfidious gallbladders—a diagnostic dilemma with xanthogranulomatous cholecystitis. Ann R Coll Surg Eng. 2007;89:168–72
• 21. Karabulut Z, Besim H, Hamamci O, Bostanoglu S, Korkmaz A. Xanthogranulomatous cholecystitis. Retrospective analysis of 12 cases. Acta Chir Belg. 2003;103:297–9
• 22. Han SH, Chen YL. Diagnosis and treatment of xanthogranulomatous cholecystitis: a report of 39 cases. Cell Biochem Biophys. 2012;64:131–5
• 23. Condilis N, Sikalias N, Mountzalia L, Vasilopoulos J, Koynnos C, Kotsifas T. Acute cholecystitis: when is the best time for laparoscopic cholecystectomy? Ann Ital Chir. 2008;79:23-7.
• 24. Costantini R, Caldaralo F, Palmieri C, Napolitano L, Aceto L, Cellini C, et al. Risk factors for conversion of laparoscopic cholecystectomy. Ann Ital Chir. 2012;83:245-52
• 25. van der Velden JJ, Berger MY, Bonjer HJ, Brakel K, Laméris JS. Can sonographic signs predict conversion of laparoscopic to open cholecystectomy? Surg Endosc.1998;12:1232-5.
• 26.Terho PM, Leppäniemi AK, Mentula PJ. Laparoscopic cholecystectomy for acute calculous cholecystitis: a retrospective study assessing risk factors for conversion and complications. World J Emerg Surg. 2016;16:11:54.
• 27. Cui Y, Zhang H, Zhao E, Cui N, Li Z. Differential diagnosis and treatment options for xanthogranulomatous cholecystitis. Med Princ Pract. 2013;22:18–23