Page 36 - World Journal of Laparoscopic Surgery

Hana Alhomoud, Mohamed Abdelmohsen
than that of common open cholecystectomy, illustrating
that XGC creates difficulty in operation.
Although XGC is a benign change of the GB with a low
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mortality rate, patients with XGC usually have a longer
hospital stay than those with cholecystitis who undergo
cholecystectomy and more postoperative complications,
including leakage of bile, bile peritonitis, GB bleeding,
hepatic abscess, infection of the incisional wound, and
cholangitis stenosis. This is largely related to difficulty in
stripping the GB, the mode of operation, and the physical
condition of the patient. 7
In spite of difficulty in surgical treatment of XGC,
the operation can be carried out successfully as long as
Fig. 2: High-power microscopic picture. Collections of foamy clinicians have a sound knowledge of the anatomical
histiocytes mixed with lymphocytes
structures of the GB, make an accurate intraoperative
diagnosis, and choose the proper mode of operation.
5-8
it occurs mostly in middle-aged and old persons. The
low incidence of XGC sometimes leads to misdiagnosis CONCLUSION
by clinicians. Differentiating XGC from GB cancer is a diagnostic
No symptoms and signs are specific for XGC; they are dilemma. Making this distinction preoperatively or
9
similar to those of acute or chronic cholecystitis. In this intraoperatively is difficult. The presence of firm adhe-
case report, the patient had the symptoms in the right hypo- sions of the GB to neighboring organs and tissues,
chondrial region and suffered from radiating pain in the thickened GB wall together with gallstones in a patient
shoulder and back, nausea, vomiting, and fever. Yet, some with chronic disease is highly suggestive of XGC. A
10
4
features on US and CT were highly suggestive of XGC, definitive diagnosis still necessitates a histopathological
including thickening of the GB wall, GB stone shadow, and examination.
adhesion to neighboring tissues and organs. Despite all
these distinctions, it is difficult to differentiate XGC from REFERENCES
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