黄色肉芽肿性胆囊炎八例误诊剖析  

Analysis of Misdiagnosis of Eight Cases of Xanthogranulomatous Cholecystitis

作　　者：谢辉[1] 王锦江[1] XIE Hui;WANG Jin-jiang(Department of General Surgery,Yan＇ an People＇ s Hospital,Yan＇ an,Shanxi 716000,China)

机构地区：[1]延安市人民医院普通外科,陕西延安716000

出　　处：《临床误诊误治》2018年第6期19-21,共3页Clinical Misdiagnosis & Mistherapy

基　　金：陕西省自然科学基金(2011KRM11)

摘　　要：目的探讨黄色肉芽肿性胆囊炎(xanthogranulomatous cholecystitis,XGC)的临床特征及误诊原因,提高诊治水平。方法回顾性分析我院收治的误诊为胆囊癌的XGC 8例临床资料。结果本组均表现为上腹部闷胀不适、右上腹隐痛,误诊为胆囊癌,误诊时间(44.38±10.62)h,均予手术治疗,依据术后病理检查结果确诊为XGC,其中2例术后切口感染,1例合并胆管炎性狭窄。随访3个月~1年,其中胆管炎性狭窄者术后6个月发生梗阻性黄疸,经胰胆管逆行造影+内支架植入引流后恢复尚可;7例预后良好。结论XGC临床症状无特异性,早期确诊可有效避免误诊误治,改善患者预后。Objective To investigate the clinical features and causes of misdiagnosis of gallbladder calculous cholecystitis（ XGC）,so as to improve the level of diagnosis and treatment. Methods A retrospective analysis was performed to analyze the clinical data of 8 case of XGC misdiagnosed as gallbladder cancer. Results All patients in this group had distension and pain in right upper abdomen,which were misdiagnosed as gallbladder cancer.The average duration of misdiagnosis was（ 44. 38 ± 10. 62） h. All the patients underwent surgical resection,and were diagnosed as XGC based on the postoperative pathological examination,including 2 cases of infection by incision,and 1 with inflammatory biliary stenosis. They were followed up for 3 months to 1 year after discharge. The patient with inflammatory biliary stenosis developed obstructive jaundice at 6 months after operation,for which ERCP ＋stent implantation was performed,and the patient recovered well. The prognosis of other 7 case was favorable. Conclusion The clinical symptoms of XGC are not specific,therefore,early diagnosis can effectively avoid misdiagnosis and mistreatment,and improve the prognosis of patients.

关 键 词：黄色肉芽肿性胆囊炎 误诊 胆囊癌 

分 类 号：R575.61[医药卫生—消化系统]