METHODS: The clinical, serological, radiological and operative features of twelve patients with obviously wall-thickening or mass-forming
xanthogranulomatous cholecystitis were retrospectively analyzed. Additionally, the patient preoperative features were compared to those of 36 patients with advanced
gallbladder cancers.
RESULTS: Twelve patients with
xanthogranulomatous cholecystitis exhibited one to three episodes of
acute cholecystitis within 0.5 to 7 months prior to admission to the hospital. Five of these patients exhibited concomitant
choledocholithiasis, whereas no concomitant
choledocholithiasis was identified in patients with advanced
gallbladder cancer. The incidence of
abdominal pain (χ(2) = 6.588, P = 0.010),
acute cholecystitis (χ(2) = 29.176, P = 0.000), acute
cholangitis (χ(2) = 6.349, P = 0.012),
choledocholithiasis (χ(2) = 16.744, P = 0.000),
carcinoembryonic antigen test (P = 0.007), CA125 (P = 0.001), and diffuse gallbladder wall thickening (χ(2) = 6.031, P = 0.014), continued mucosal line (χ(2) = 15.745, P = 0.000), homogeneous enhancement of mucosal line (χ(2) = 19.947, P = 0.000), submucosal hypoattenuated nodules or band (χ(2) = 18.607, P = 0.000) in computed tomography demonstrated statistically significant differences between cases of
xanthogranulomatous cholecystitis and
gallbladder cancer. Furthermore, all the twelve patients with
xanthogranulomatous cholecystitis exhibited at least one positive computed tomography imaging feature aside from past
acute cholecystitis episode, and no patient with advanced
gallbladder cancer simultaneously exhibited past
acute cholecystitis episode and at least one positive computed tomography imaging feature.
CONCLUSIONS: