{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T18:50:04Z","timestamp":1791917404175,"version":"4.3.4"},"reference-count":20,"publisher":"Wiley","issue":"1-2","license":[{"start":{"date-parts":[[2016,9,6]],"date-time":"2016-09-06T00:00:00Z","timestamp":1473120000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Xanthogranulomatous cholecystitis (<jats:styled-content style=\"fixed-case\">XGC<\/jats:styled-content>) is an uncommon variant of chronic cholecystitis, characterized by a focal or diffuse destructive inflammatory process. The importance of <jats:styled-content style=\"fixed-case\">XGC<\/jats:styled-content> is that it mimics gall bladder carcinoma (<jats:styled-content style=\"fixed-case\">GBC<\/jats:styled-content>) both preoperatively and intra\u2010operatively, as it can present with pericholecystic infiltration, hepatic involvement and lymphadenopathy. As a result of a misdiagnosis, which is not infrequent, the patient may undergo an unnecessary radical cholecystectomy rather than only a cholecystectomy, which is associated with a greater morbidity and mortality. The main aim of the study is to formulate a simple preoperative scoring system for diagnosis of XGC which might benefit patients by avoiding radical procedures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective study was done from all the patients who underwent gall bladder and gall bladder\u2010related operations (benign and malignant), during a 5\u2010year time period from 2010 to 2014 in a tertiary care centre were reviewed (<jats:italic>n<\/jats:italic> = 462).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Initial analyses of all the clinical and imaging parameters were done. Patients with a long history of recurrent abdominal pain with leucocytosis and who on imaging are found to have a diffusely thickened gall bladder wall, cholelithiasis, choledocholithiasis and submucosal hypoattenuated nodules are likely to have <jats:styled-content style=\"fixed-case\">XGC<\/jats:styled-content> while those with anorexia, weight loss, focal thickening of the gall bladder wall on imaging and dense local organ infiltration are more likely to have <jats:styled-content style=\"fixed-case\">GBC<\/jats:styled-content>. The presence of lymph nodes on imaging and the loss of a fat plane interface between the liver and gall bladder are not differentiating factors. A scoring system was made by taking statistically significant features (<jats:italic>n<\/jats:italic> = 13) of clinical and imaging parameters in initial assessment to identify the features of <jats:styled-content style=\"fixed-case\">XGC<\/jats:styled-content>. The same scoring system was subsequently applied to the patients who underwent cholecystectomy to study the effectiveness and the results were reviewed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>High value scores (\u226511\/13) helps in diagnosing <jats:styled-content style=\"fixed-case\">XGC<\/jats:styled-content> in preoperative setting. Hence, intra\u2010operative frozen section analysis can be avoided in such cases to differentiate <jats:styled-content style=\"fixed-case\">XGC<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">GBC<\/jats:styled-content>. However in difficult cases with high suspicion of malignancy based on clinical experience, definitive diagnosis still remains a histopathological examination to avoid radical resection in patients who have a benign condition.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.13733","type":"journal-article","created":{"date-parts":[[2016,9,6]],"date-time":"2016-09-06T23:42:55Z","timestamp":1473205375000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["New scoring system for differentiating xanthogranulomatous cholecystitis from gall bladder carcinoma: a tertiary care centre experience"],"prefix":"10.1111","volume":"88","author":[{"given":"Kishore","family":"Rajaguru","sequence":"first","affiliation":[{"name":"Department of Surgical Gastroenterology and Liver Transplantation Sir Ganga Ram Hospital  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siddharth","family":"Mehrotra","sequence":"additional","affiliation":[{"name":"Department of Surgical Gastroenterology and Liver Transplantation Sir Ganga Ram Hospital  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shailendra","family":"Lalwani","sequence":"additional","affiliation":[{"name":"Department of Surgical Gastroenterology and Liver Transplantation Sir Ganga Ram Hospital  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivek","family":"Mangla","sequence":"additional","affiliation":[{"name":"Department of Surgical Gastroenterology and Liver Transplantation Sir Ganga Ram Hospital  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naimish","family":"Mehta","sequence":"additional","affiliation":[{"name":"Department of Surgical Gastroenterology and Liver Transplantation Sir Ganga Ram Hospital  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samiran","family":"Nundy","sequence":"additional","affiliation":[{"name":"Department of Surgical Gastroenterology and Liver Transplantation Sir Ganga Ram Hospital  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,9,6]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800810735"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v12.i14.2293"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1308\/003588407X155833"},{"key":"e_1_2_6_5_1","first-page":"423","article-title":"Benign tumors and pseudotumors of the gallbladder. Report of 180 cases","volume":"90","author":"Christensen AH","year":"1970","journal-title":"Arch. Pathol."},{"key":"e_1_2_6_6_1","first-page":"78","article-title":"Xanthogranulomatous cholecystitis. Report of two cases","volume":"72","author":"McCoy JJ","year":"1976","journal-title":"J. S. C. Med. Assoc."},{"key":"e_1_2_6_7_1","first-page":"109","article-title":"Strategies for diagnosis of xanthogranulomatous cholecystitis masquerading as gallbladder cancer","volume":"125","author":"Zhang L\u2010F","year":"2012","journal-title":"Chin Med J"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.203.1.9122374"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.203.1.9122422"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0009-9260(98)80129-3"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-003-1931-7"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-002-1731-5"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.crad.2013.03.022"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gassur.2003.10.003"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1159\/000332533"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1159\/000325680"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2010.05.022"},{"key":"e_1_2_6_18_1","first-page":"504","article-title":"Surgical treatment of xanthogranulomatous cholecystitis: experience in 33 cases","volume":"6","author":"Yang T","year":"2007","journal-title":"Hepatobiliary Pancreat. Dis. Int."},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-008-0478-y"},{"key":"e_1_2_6_20_1","first-page":"31","article-title":"Xanthogranulomatous cholecystitis: differentiation from associated gall bladder carcinoma","volume":"26","author":"Rao RV","year":"2005","journal-title":"Trop. Gastroenterol."},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.4103\/0972-9941.115368"}],"container-title":["ANZ Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fans.13733","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fans.13733","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ans.13733","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T12:49:39Z","timestamp":1695559779000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ans.13733"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,9,6]]},"references-count":20,"journal-issue":{"issue":"1-2","published-print":{"date-parts":[[2018,1]]}},"alternative-id":["10.1111\/ans.13733"],"URL":"https:\/\/doi.org\/10.1111\/ans.13733","archive":["Portico"],"relation":{},"ISSN":["1445-1433","1445-2197"],"issn-type":[{"value":"1445-1433","type":"print"},{"value":"1445-2197","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,9,6]]},"assertion":[{"value":"2016-05-31","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-07-20","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-09-06","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}