Shen Bai-Yong, Regimbeau Jean-Marc, Li Hong-Wei
Department of Surgery, Ruijin Hospital, Shanghai Second Medical University, Shanghai 200025, China.
Hepatobiliary Pancreat Dis Int. 2005 May;4(2):313-5.
Despite its rare incidence, few cases of left-side gallbladder have been already published.
We reported herein the case of a 29-year-old man with a left liver tumor in whom left lateral bisegmentectomy was mandatory. It represents the first description of a sinistroposition of both gallbladder and common bile duct.
Surgical exploration revealed a left-side gallbladder, located under the left lobe of the liver. During hepatic parenchyma dissection at the left side of the round ligament and the Rex recessus, the common bile duct was injured. Complete separation of hepatic pedicle structures showed that the upper biliary convergence passed on the left side of the Rex recessus before reaching the hepatoduodenal ligament.
Only careful dissection of the hepatoduodenal ligament up to Rex recessus level prior to liver parenchyma resection could avoid biliary tract injury during left lobectomy.
尽管左侧胆囊的发病率很低，但已有少数病例发表。
我们在此报告一例29岁男性左肝肿瘤患者，必须进行左外侧双段切除术。这是首次对胆囊和胆总管均位于左侧的情况进行描述。
手术探查发现左侧胆囊位于肝左叶下方。在圆韧带左侧和雷氏隐窝处进行肝实质解剖时，胆总管受损。肝蒂结构的完全分离显示，上胆管汇合在到达肝十二指肠韧带之前，先经过雷氏隐窝左侧。
在肝实质切除术前，只有仔细解剖肝十二指肠韧带直至雷氏隐窝水平，才能避免左叶切除术中的胆道损伤。
