Laparoscopic cholecystectomy for xanthogranulomatous cholecystitis: 18 years of experience

Abstract

Abstract Introduction Xanthogranulomatous cholecystitis (XGC) is a rare inflammatory disease of the gallbladder(GB). It has been classified as an uncommon variant of chronic cholecystitis with a prevalence of 0.7 to 10%. It is a difficult diagnosis because macroscopic appearance may be confused with gallbladder cancer (GC). Laparoscopic cholecystectomy is the gold standard for the management of benign gallbladder disease. Laparoscopic cholecystectomy in XGC is associated with a high conversion rate to open cholecystectomy with a rate of 10.6 to 80%. Material and methods A descriptive, observational, retrospective, and cross-sectional study was carried out over a period of 18 years at a general hospital on Mexico City. Patients with histopathological diagnosis of xanthogranulomatous cholecystitis were included. This study was retrospectively registered and approved by the board of ethical committee in our institution on 2018. Results We recorded 142 patients, and 106 surgeries were performed totally laparoscopically (74.6%). 52 were emergency surgeries (49%) and 54 elective (51%). The conversion rate to open cholecystectomy was 3.7% (4 patients). There were 5 post-surgical complications (4.7%) one biloma, one surgical site infection, and 3 pancreatitis. Conclusions XGX represents a surgical challenge from diagnosis to surgical management and is associated to a higher number of perioperative complications. Nevertheless, a laparoscopic approach is safe in high volume centers with experience in laparoscopy.