Abstract
Xanthogranulomatous cholecystitis is an variant of chronic cholecystitis resulting in thickened gallbladder wall mimicking gallbladder carcinoma. Several authors reported significant incidence of co-existing occult gallbladder carcinoma (3 to 13%). XGC has some characteristic imaging findings, such as a continuity of the mucosal layer, hypo-attenuated lesions in the gallbladder wall, and a impacted stone at the gallbladder neck. In the case with hilar biliary stricture, treatment strategy is notably difficult. ERCP brush cytology is not reliable enough because of its low sensitivity. In such instances, as the further study, EUSFNA should be considered. Recent reports have achieved a satisfactory negative predictive value. For the patients with negative cytologic examination, simple cholecystectomy with adequate minimum liver resection and frozen section diagnosis of the cystic duct can be performed. Furthermore, patients with severe co-morbidities or elderly may be closely observed without surgery if there is no obvious findings suggesting GB cancer. Making a large-scale database is desirable to establish better strategy of diagnosis and treatment of XGC.
