Published online Dec 28, 2017. doi: 10.3748/wjg.v23.i48.8671
Peer-review started: September 13, 2017
First decision: October 10, 2017
Revised: October 13, 2017
Accepted: November 21, 2017
Article in press: November 21, 2017
Published online: December 28, 2017
Xanthogranulomatous cholecystitis (XGC) is an uncommon variant of chronic cholecystitis. The perioperative findings in aggressive cases may be indistinguishable from those of gallbladder or biliary tract carcinomas. Three patients presented mass lesions that infiltrated the hepatic hilum, provoked biliary dilatation and jaundice, and were indicative of malignancy. Surgical excision was performed following oncological principles and included extirpation of the gallbladder, extrahepatic bile duct, and hilar lymph nodes, as well as partial hepatectomy. Postoperative morbidity was minimal. Surgical pathology demonstrated XGC and absence of malignancy in all three cases. All three patients are alive and well after years of follow-up. XGC may have such an aggressive presentation that carcinoma may only be ruled out on surgical pathology. In such cases, the best option may be radical resection following oncological principles performed by expert surgeons, in order that postoperative complications may be minimized if not avoided altogether.
Core tip: Though it is a benign disease process, xanthogranulomatous cholecystitis may have an aggressive presentation suggestive of a carcinoma of the gallbladder or biliary tract. In such cases, the best option may be surgical resection performed by expert surgeons following oncological principles, in order to cure affected patients without provoking postoperative morbidity.