Background

Xanthogranulomatous cholecystitis (XGC) is a rare benign chronic inflammatory disease of the gallbladder that often presents as cholecystitis and most of the times requires surgical management. In addition, distinguishing XGC from gallbladder cancer preoperatively is still a challenge. The aim of the present systematic review was to outline the clinical presentation and surgical approach of XGC.

Data sources

The present systematic review was designed using the PRISMA and AMSTAR guidelines. We searched MEDLINE, Scopus, Clinicaltrials.gov, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL) and Google Scholar databases from inception until June 2020.

Results

The laparoscopic cholecystectomy rate (34%) was almost equal to the open cholecystectomy rate (47%) for XGC. An important conversion rate (35%) was observed as well. The XGC cases treated by surgery were associated with low mortality (0.3%), limited intraoperative blood loss (58-270 mL), low complication rates (2%–6%), along with extended operative time (82.6–120 minutes for laparoscopic and 59.6–240 minutes for open cholecystectomy) and hospital stay (3–9 days after laparoscopic and 8.3–18 days after open cholecystectomy). Intraoperative findings during cholecystectomies for XGC included empyema or Mirizzi syndrome. In addition, complex surgical procedures, like wedge hepatic resections and bile duct excision were required during operations for XGC.

Conclusions

XGC seemed to be a rare, benign inflammatory disease that presents similar features as gallbladder cancer. The mortality and complication rates of XGC were low, despite the complex surgical procedures that might be required in some cases.

中文翻译：

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黄色肉芽肿性胆囊炎的表现和手术治疗

背景

黄色肉芽肿性胆囊炎（XGC）是一种罕见的良性胆囊慢性炎症性疾病，常表现为胆囊炎，大多数情况下需要手术治疗。此外，术前区分 XGC 和胆囊癌仍然是一个挑战。本系统评价的目的是概述 XGC 的临床表现和手术方法。

数据源

本系统评价是使用 PRISMA 和 AMSTAR 指南设计的。我们检索了 MEDLINE、Scopus、Clinicaltrials.gov、EMBASE、Cochrane Central Register of Controlled Trials (CENTRAL) 和 Google Scholar 数据库，从开始到 2020 年 6 月。

结果

XGC 的腹腔镜胆囊切除术率 (34%) 几乎等于开腹胆囊切除术率 (47%)。还观察到了重要的转化率 (35%)。手术治疗的 XGC 病例死亡率低（0.3%），术中失血量有限（58-270 mL），并发症发生率低（2%-6%），手术时间延长（腹腔镜 82.6-120 分钟）开腹胆囊切除术 59.6-240 分钟）和住院时间（腹腔镜手术后 3-9 天，开腹胆囊切除术后 8.3-18 天）。XGC 胆囊切除术的术中发现包括脓胸或 Mirizzi 综合征。此外，XGC在手术过程中需要复杂的外科手术，如楔形肝切除术和胆管切除术。

结论

XGC 似乎是一种罕见的良性炎症性疾病，具有与胆囊癌相似的特征。尽管在某些情况下可能需要复杂的外科手术，但 XGC 的死亡率和并发症发生率很低。