Xanthogranulomatous Cholecystitis
A rare destructive inflammatory condition of the gallbladder mimicking cancer.
Overview
Xanthogranulomatous cholecystitis is an uncommon, intense form of chronic gallbladder inflammation. It causes marked thickening and scarring of the gallbladder wall and can closely mimic gallbladder cancer on imaging and even during surgery. Treatment is surgical removal of the gallbladder, with careful assessment to exclude cancer.
Causes
- Long-standing gallstones and gallbladder inflammation
- Rupture of small gland-like structures within the gallbladder wall
- Chronic obstruction of the gallbladder
Risk Factors
- Long-standing gallstones
- Recurrent gallbladder inflammation
- Age 50–70
- Delayed treatment of symptomatic gallstones
Symptoms
Diagnosis
- Ultrasound abdomen
- CT abdomen
- MRI
- Difficulty distinguishing from gallbladder cancer on imaging
- Histopathology (confirms the diagnosis definitively)
Treatment Options
Surgical Treatment
Cholecystectomy is the definitive treatment. Because of dense inflammation and scarring, surgery is often more challenging and may require an open approach. Since it can be indistinguishable from gallbladder cancer, Dr. Bhagat uses intraoperative frozen section assessment when needed, and is prepared to perform a more extensive resection if cancer cannot be confidently excluded.
Recovery
Recovery depends on whether laparoscopic or open surgery was performed and the extent of inflammation. Hospital stay ranges from a couple of days to about a week. Once removed and confirmed benign, the outlook is excellent.
Prevention
- Timely treatment of symptomatic gallstones
- Not delaying surgery for recurrent gallbladder inflammation
- Prompt evaluation of persistent right upper abdominal pain
Frequently Asked Questions
Why can it be confused with gallbladder cancer?
Is this condition cancerous?
Expert Consultation Available
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