Ksantogranülomatöz kolesistitin cerrahi üzerine etkisi

Yıl 2021, Cilt: 46 Sayı: 4, 1351 - 1359, 30.12.2021

Merih Altıok Feyzi Kurt

https://doi.org/10.17826/cumj.976851

Öz

Amaç:. Bu çalışmada biliyer staza neden olan patolojilerin ksantogranülomatöz kolesistit (XGC) ile birlikte görülme sıklığı ve konversiyon kolesistektomiye etkisinin değerlendirilmesi amaçlanmıştır.
Gereç ve Yöntem: Bu retrospektif çalışmada Ocak 2010-Haziran 2020 tarihleri arasında Seyhan Devlet Hastanesi'nde kolesistektomi yapılan 11840 hastanın tıbbi kayıtları incelendi. Tıbbi kayıtlar incelendikten sonra patolojik olarak XGC tanısı alan hastalar çalışmaya dahil edildi.
Bulgular: Son on yılda kolesistektomi yapılan toplam 11840 hastanın 40'ına (%0.33) XGC tanısı kondu. Olguların yaş ortalaması 58 (34-88) idi. 40 hastanın 26'sında (%65) ameliyat laparoskopik olarak tamamlandı. Bunların 5'ine (%12,5) açık cerrahi uygulandı. Dokuz (%22.5) hastada laparoskopik kolesistektomiden açık cerrahiye geçildi. Tüm kolesistektomi olgularında konversiyon kolesistektomi(KK) oranı 412/11840 (%3.4) idi. Safra yolları ile ilgili tanı ve tedavi amaçlı 13 (%32.5) hastaya endoskopik retrograd kolanjiyopankreatografi (ERCP) yapıldı. Histopatolojik incelemede safra kesesi duvar kalınlığı ortalama 8,0 milimetre (± 3,87) olarak bulundu. 38 (%95) hastada duvar kalınlığında 4 milimetre veya daha fazla artış vardı. Safra stazına neden olan patolojinin alt grup analizinde ve acil kolesistektomi yapılan hastalarda KK oranı yüksek bulundu.
Sonuç: Bu çalışma ışığında XGC hastalarında safra stazına neden olan patolojilerin diğer kolesistit hastalarına göre daha sık görülmesi bu patolojilerin XGC etiyolojisi ile ilişkili olabileceğini düşündürmektedir.

Anahtar Kelimeler

Konversiyon kolesistektomi, ksantogranülomatöz kolesistit, laparoskopi, safra kesesi

Effect of xanthogranulomatous cholecystitis on surgery

Öz

Purpose: The aim of this study is to evaluate the incidence of pathologies causing biliary stasis together with xanthogranulomatous cholecystitis (XGC) and its effect on conversion to open cholecystectomy.
Materials and Methods: This retrospective study reviewed the medical records of 11840 patients who underwent cholecystectomy at Seyhan State Hospital between January 2010 and June 2020. After examining the medical records, 40 (0.33%) of 11840 cholecystectomy cases were diagnosed as XGC pathologically.
Results: In the last decade, 40 (0.33%) patients out of a total of 11840 patients who underwent cholecystectomy were diagnosed with XGC. The mean age of the cases was 58 (34-88). In 26 (65%) of 40 patients, surgery was completed laparoscopically. Open surgery was performed in 5 (12.5%) of them. Nine (22.5%) patients were converted from laparoscopic cholecystectomy to open surgery. In all cholecystectomy cases, the conversion cholecystectomy(CC) rate was 412/11840 (3.4%). Endoscopic retrograde cholangiopancreatography(ERCP) was performed in 13 (32.5%) patients for diagnosis and therapeutic purposes related to bile ducts. The gallbladder wall's average thickness was found to be 8.0 millimeters (± 3.87) on histopathological examination. 38 (95%) patients had an increase in gall bladder wall thickness of 4 millimeters or more. CC rate was found to be high in the subgroup analysis of pathology causing bile stasis and in patients who underwent emergency cholecystectomy.
Conclusion: This study demonstrates that the pathologies causing bile stasis are observed more frequently in XGC patients than other cholecystitis patients, suggesting that these pathologies may be associated with XGC.

Anahtar Kelimeler

Conversion cholecystectomy, gallbladder, laparoscopy, xanthogranulomatous cholecystitis

Kaynakça

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