Department of Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India.
HPB (Oxford). 2002;4(1):39-42. doi: 10.1080/136518202753598726.
Aberrant gallbladder beneath the left liver is a rare congenital anomaly that is found in 0.1-0.7 per cent of the population and causes confusion on imaging and at operation.Two such cases are presented.
A man of 83 yr was explored for obstructive jaundice due to a hilar tumour, but the gallbladder was 'missing'. Exploration of a cystic mass to the left of the falciform ligament revealed a gallbladder attached to segment III of the liver. Laparotomy for gallstones in a woman of 70 yr failed to reveal the gallbladder until further dissection was carried out to the left of the falciform ligament. In each of these cases the cystic duct described a hairpin bend before joining the common hepatic duct on its right-hand side.
A left-sided gallbladder can be truly ectopic or may just appear so because the falciform ligament is aberrantly placed to the right. In either case preoperative imaging can be misleading, and a careful search is needed at operation. The incidence of disease seems no commoner than in orthotopic gallbladders.
左肝下异常胆囊是一种罕见的先天性异常，在 0.1%至 0.7%的人群中发现，在影像学和手术中引起混淆。现介绍两例这种病例。
一名 83 岁男性因肝门肿瘤导致阻塞性黄疸而接受探查，但胆囊“缺失”。在镰状韧带左侧探查囊性肿块时，发现一个附着在肝段 III 上的胆囊。一名 70 岁女性因胆囊结石行剖腹术，直到在镰状韧带左侧进一步解剖，才发现胆囊。在这两种情况下，胆囊管在右侧与肝总管汇合之前都描述了一个发夹状弯曲。
左位胆囊可能是真正的异位，也可能只是因为镰状韧带异常地位于右侧而显得如此。在任何一种情况下，术前影像学都可能具有误导性，因此需要在手术中进行仔细的搜索。疾病的发病率似乎并不比正常胆囊更常见。
