Ahmet Oğuz HASDEMİR, Demet YILMAZER, Şener BALAS, Muzaffer AKKOCA, Cem AZILI, Serhat TOKGÖZ, Kerim Bora YILMAZ

Ksantogranülomatöz Kolesistit Vakalarının Analizi

Amaç: Ksantogranulomatöz kolesistit (XGC), safra tașı ve safra stazı bağlı gelișen inflamatuar bir durumdur. Patolojik, radyolojik ve klinik özellikleri safra kesesi kanserine benzediğinden, așırı veya yetersiz cerrahi gibi yanlıș tedavilere neden olmaktadır. Bu çalıșmada XGC olgularının klinik ve cerrahi özelliklerini belirlemek amaçlanmıștır. Gereç ve Yöntem: Kliniğimizde 2008 ile 2015 yılları arasında kolesistektomi yapılan 4818 hastadan XGC tanısı alan 55 hastanın tıbbi kayıtları incelendi. Bulgular: En sık rastlanan klinik bulgu (% 90) sağ üst kadran ağrısıydı. Hastaların % 30’unda ise akut kolesistit tablosu mevcuttu. Bilier duvar kal ınlașması hastaların% 64'ünde bulundu. Laparaskopik kolesistektomiden açığa dönüș oranı ise %39 olarak bulundu ve bu oran tüm kolesistektomilerin konversiyon oranı %3.4 ile karșılaștırıldığında oldukça yüksekti. Postoperatif bilier fistül % 9 ve toplam morbidite ise % 23 olarak tespit edildi. Sonuç: XGC nadir bir kolesistit formudur. Histolojik olarak benign olmasına rağmen, preoperatif ve intraoperatif tanı agresif seyri nedeniyle zor ve karmașıktır. XGC'de ameliyat sırasında karsinom șüphesi olmasına rağmen ilișkisi çok yüksek değildir. Daha kapsamlı cerrahiden kaçınmak için frozen incelenmesi oldukça yararlıdır. Kesin tedavi ameliyattır ancak ameliyat sırasında ve sonrasında yüksek morbidite oranları olduğu unutulmamalıdır.

An Analysis of Xanthogranulomatous Cholecystitis Cases

Aim: Xanthogranulomatous cholecystitis (XGC) is usually an inflammatory condition due to gallstones and bile stasis. Pathological, radiological and clinical features are similar to gallbladder cancer, leading to erroneous treatments such as excessive or inadequate surgery. The aim of this study was to identify the clinical and surgical characteristics of XGC cases.Materials and Methods: The medical records were reviewed of 55 patients diagnosed as XGC from 4818 patients who underwent cholecystectomy between 2008 and 2015.Results: The most common clinical finding (90%) was right upper quadrant pain, followed by acute cholecystitis (30%). Biliary wall thickening was found in 64% of patients. Conversion to open cholecystectomy rate was 39%, which was significantly higher than that of all cholecystectomies conversion rates 3.4%. Postoperative biliary fistula was determined at 9% and total morbidity at 23%.Conclusion: XGC is a rare form of cholecystitis. Although it is histologically benign, preoperative and intraoperative diagnosis is difficult and complicated due to its aggressive course. Although carcinoma may be suspected during surgery in XGC, the association is not very high. It is quite useful to study frozen samples to avoid extensive surgery. The definitive treatment is surgery, but it should not be forgotten that there are high morbidity rates during and after the operation

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