First Propaedeutic Department of Surgery, Hippocration General Hospital, National and Kapodistrian University of Athens, School of Medicine, 114 Vas. Sofias Ave. 11527, Athens, Greece; Laboratory of Experimental Surgery and Surgical Research, National and Kapodistrian University of Athens, School of Medicine, 15B Ag. Thoma Str. 11527, Athens, Greece.
First Department of Surgery, Laikon General Hospital, National and Kapodistrian University of Athens, School of Medicine, 17 Ag. Thoma Str. 11527, Athens, Greece; Society of Junior Doctors, Surgery Workgroup, 75 Mikras Asias Str. 11527, Athens, Greece.
Hepatobiliary Pancreat Dis Int. 2021 Apr;20(2):117-127. doi: 10.1016/j.hbpd.2021.01.002. Epub 2021 Jan 22.
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.
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.
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.
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.
黄色肉芽肿性胆囊炎（XGC）是一种罕见的良性慢性胆囊炎症性疾病，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 和胆囊癌仍然具有挑战性。本系统综述的目的是概述 XGC 的临床表现和手术方法。
本系统综述按照 PRISMA 和 AMSTAR 指南进行设计。我们检索了 MEDLINE、Scopus、Clinicaltrials.gov、EMBASE、Cochrane 对照试验中心注册库（CENTRAL）和 Google Scholar 数据库，检索时间从建库起至 2020 年 6 月。
XGC 的腹腔镜胆囊切除术率（34%）几乎与开腹胆囊切除术率（47%）相等。也观察到较高的中转开腹率（35%）。手术治疗的 XGC 病例死亡率低（0.3%），术中出血量少（58-270ml），并发症发生率低（2%-6%），手术时间延长（腹腔镜手术 82.6-120 分钟，开腹手术 59.6-240 分钟），住院时间延长（腹腔镜手术后 3-9 天，开腹手术后 8.3-18 天）。XGC 行胆囊切除术时的术中发现包括积脓或 Mirizzi 综合征。此外，在 XGC 手术中可能需要进行复杂的手术，如楔形肝切除术和胆管切除术。
XGC 似乎是一种罕见的良性炎症性疾病，其表现与胆囊癌相似。尽管某些情况下可能需要复杂的手术，但 XGC 的死亡率和并发症发生率较低。
