Gertner Michael, Farmer Diana L
Division of Pediatric Surgery, Department of Surgery, University of California, San Francisco, San Francisco, CA 94143-0570, USA.
J Pediatr Surg. 2004 Jan;39(1):E17-9. doi: 10.1016/j.jpedsurg.2003.09.034.
A 16-day-old girl with demonstrated evidence of cholelithiasis was treated initially conservatively on the assumption that the gallstone would resolve spontaneously. However, when repeat ultrasound scan showed a large gallstone and intrahepatic ductal dilatation indicative of antenatal common duct obstruction, the infant underwent laparoscopic cholecystectomy with an intraoperative cholangiogram. The patient did well postoperatively and was on regular feeding by postoperative day 1. An intraoperative cholangiogram showed an impacted stone in the infidibulum of the gallbladder. Gross and histopathologic findings indicated chronic cholecystitis. Based on an extensive review of the literature, this case appears to be the first reported incidence of chronic cholecystitis in a neonate and that of the youngest patient to undergo a laparoscopic cholecystectomy with intraoperative cholangiogram.
一名16天大的女孩被证实患有胆结石,最初因认为胆结石会自行消退而采取保守治疗。然而,当重复超声扫描显示有一颗大的胆结石以及肝内胆管扩张提示产前胆总管梗阻时,该婴儿接受了腹腔镜胆囊切除术及术中胆管造影。患者术后恢复良好,术后第1天即可正常进食。术中胆管造影显示胆囊漏斗部有一颗嵌顿结石。大体和组织病理学检查结果提示慢性胆囊炎。基于对文献的广泛回顾,该病例似乎是首次报道的新生儿慢性胆囊炎病例,也是接受腹腔镜胆囊切除术及术中胆管造影的最年轻患者。