黄色肉芽肿性胆囊炎的临床诊断及治疗分析

【】目的探讨黄色肉芽肿性胆囊炎的诊断与治疗，提高对该疾病的认识及诊治水平。方法对2004年9月-2009年10月确诊为黄色肉芽肿性胆囊炎的15例患者资料进行回顾性分析。结果确诊为黄色肉芽肿性胆囊炎3例，慢性胆囊炎8例，胆囊癌4例。10例行胆囊切除术，2例行胆囊切除加胆总管探查T管引流术，1例行胆囊大部切除加十二指肠瘘修补术，1例行胆囊大部切除加胃瘘修补术，1例行胆囊切除加胆囊床部肝组织切除。术后并发胆瘘1例，切口感染2例。无死亡病例。结论黄色肉芽肿性胆囊炎术前难诊断，术中冷冻切片检查和术后病理检查是诊断的关键，手术切除胆囊是主要治疗方法。？【Abstract】ObjectiveToevaluatetheclinicaldiagnosisandtreatmentofxanthogranulomatouscholecystitis.MethodsTheclinicaldataof15patientswithxanthogranulomatouscholecystitistreatedinourhospitalfromSeptember2004toOctober2009wereretrospectivelyanalyzed.ResultsAllof15patientswerediagnosedasxanthogranulomatouscholecystitisthroughpostoperativepathologicexamination,including3werediagnosedasxanthogranulomatouscholecystitis,8werediagnosedaschroniccholecystitis,and4werediagnosedasgallbladdercarcinoma.Allpatientsunderwenttheoperationsincludingcholecystectomyin10,cholecystectomypluscholedochojejunostomyandTtubedrainagein2,gallbladdersubtotalplusduodenalfistulain1,gallbladdersubtotalresectionofgastricfistulain1,andcholecystectomyplusthedepartmentofthegallbladderbedresectionoflivertissuein1.Thepostoperativecomplicationsincludedbiliaryfistulain1caseandwoundinfectionin2cases;nodeathswerefound.ConclusionXanthogranulomatouscholecystitisisdifficulttodiagnosebeforetheoperations.Thekeysofthediagnosisaretheintraoperativefrozensectionexaminationandpostoperativepathologicexamination.Cholecystectomyisthemainoperationforxanthogranulomatouscholecystitis.？