目的 分析黄色肉芽肿性胆囊炎(XGC)误诊为胆囊癌的原因,探讨XGC的诊断和治疗策略。
方法 回顾性分析2012年我科收治的2例XGC误诊为胆囊癌患者的临床病理资料。
结果 2例患者术前及术中均误诊为胆囊癌,均行胆囊切除+肝脏Ⅳ、Ⅴ段切除+胆道镜下胆总管探查术,其中1例还行肝门周围淋巴结清扫。术后病理回报均为XGC。2例患者术后均恢复良好,无手术并发症发生;均随访3个月,生活质量好。
结论 临床上根据XGC的症状和影像学表现极易误诊为胆囊癌,建议术中冰冻病理明确诊断后选择合适的术式,防止盲目扩大手术范围,减少机体损伤和术后并发症的发生。
Citation:
吴晔,王震侠,宝力道,胡利强,程然,严律南. Clinical Analysis of Xanthogranulomatous Cholecystitis Misdiagnosed as Gallbladder Cancer (Report of 2 Cases). CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2013, 20(2): 206-208. doi:
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Christensen AH, Ishak KG. Benign tumors and pseudotumors of the gallbladder. Report of 180 cases[J]. Arch Pathol, 1970, 90(5):423-432.
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McCoy JJ Jr, Vila R, Petrossian G, et al. Xanthogranulomatous cholecystitis. Report of two cases[J]. JSC Med Assoc, 1976, 72(3):78-79.
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Guzmán-Valdivia G. Xanthogranulomatous cholecystitis in laparoscopic surgery[J]. J Gastrointest Surg, 2005, 9(4):494-497.
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杨田, 杨立群, 张柏和, 等. 黄色肉芽肿性胆囊炎误诊为胆囊癌十例分析[J]. 中华普通外科杂志, 2006, 21(10):712-714.
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Enomoto T, Todoroki T, Koike N, et al. Xanthogranulomatous cholecystitis mimicking stageⅣgallbladder cancer[J]. Hepatogastroenterology, 2003, 50(53):1255-1258.
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6. |
Koh T, Taniguchi H, Yamaguchi A, et al. Differential diagnosis of gallbladder cancer using positron emission tomography with fluorine-18-labeled fluoro-deoxyglucose (FDG-PET)[J]. J Surg Oncol, 2003, 84(2):74-81.
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7. |
杨田, 孙经建. 黄色肉芽肿性胆囊炎与胆囊癌的临床鉴别[J]. 国际外科学杂志, 2006, 33(5):338-341.
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8. |
刘由军, 徐敏, 黄华福, 等. 黄色肉芽肿性胆囊炎影像诊断[J]. 江西医学院学报, 2009, 49(10):41-43.
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安刚, 薛福善. 现代麻醉学技术[M]. 北京:科学技术出版社, 1996:690.
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Guzmán-Valdivia G. Xanthogranulomatous cholecystitis:15 years’-experience[J]. World J Surg, 2004, 28(3):254-257.
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11. |
Shetty GS, Abbey P, Prabhu SM, et al. Xanthogranulomatous cholecystitis:sonographic and CT features and differentiation from gallbladder carcinoma:a pictorial essay[J]. Jpn J Radiol, 2012, 30(6):480-485.
|
12. |
王兰, 陶自坚. 黄色肉芽肿性胆囊炎41例临床病理分析[J]. 临床与实验病理学杂志, 2002, 18(6):619-621.
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- 1. Christensen AH, Ishak KG. Benign tumors and pseudotumors of the gallbladder. Report of 180 cases[J]. Arch Pathol, 1970, 90(5):423-432.
- 2. McCoy JJ Jr, Vila R, Petrossian G, et al. Xanthogranulomatous cholecystitis. Report of two cases[J]. JSC Med Assoc, 1976, 72(3):78-79.
- 3. Guzmán-Valdivia G. Xanthogranulomatous cholecystitis in laparoscopic surgery[J]. J Gastrointest Surg, 2005, 9(4):494-497.
- 4. 杨田, 杨立群, 张柏和, 等. 黄色肉芽肿性胆囊炎误诊为胆囊癌十例分析[J]. 中华普通外科杂志, 2006, 21(10):712-714.
- 5. Enomoto T, Todoroki T, Koike N, et al. Xanthogranulomatous cholecystitis mimicking stageⅣgallbladder cancer[J]. Hepatogastroenterology, 2003, 50(53):1255-1258.
- 6. Koh T, Taniguchi H, Yamaguchi A, et al. Differential diagnosis of gallbladder cancer using positron emission tomography with fluorine-18-labeled fluoro-deoxyglucose (FDG-PET)[J]. J Surg Oncol, 2003, 84(2):74-81.
- 7. 杨田, 孙经建. 黄色肉芽肿性胆囊炎与胆囊癌的临床鉴别[J]. 国际外科学杂志, 2006, 33(5):338-341.
- 8. 刘由军, 徐敏, 黄华福, 等. 黄色肉芽肿性胆囊炎影像诊断[J]. 江西医学院学报, 2009, 49(10):41-43.
- 9. 安刚, 薛福善. 现代麻醉学技术[M]. 北京:科学技术出版社, 1996:690.
- 10. Guzmán-Valdivia G. Xanthogranulomatous cholecystitis:15 years’-experience[J]. World J Surg, 2004, 28(3):254-257.
- 11. Shetty GS, Abbey P, Prabhu SM, et al. Xanthogranulomatous cholecystitis:sonographic and CT features and differentiation from gallbladder carcinoma:a pictorial essay[J]. Jpn J Radiol, 2012, 30(6):480-485.
- 12. 王兰, 陶自坚. 黄色肉芽肿性胆囊炎41例临床病理分析[J]. 临床与实验病理学杂志, 2002, 18(6):619-621.