Borghi Felice, Giraudo Giorgio, Geretto Paolo, Ghezzo Luigi
Department of Surgery, Azienda Ospedaliera Santa Croce e Carle, Cuneo, Italy.
J Laparoendosc Adv Surg Tech A. 2008 Jun;18(3):429-31. doi: 10.1089/lap.2007.0088.
Gallbladder congenital duplication is a rare disease difficultly diagnosed preoperatively. Eight days after a laparoscopic cholecystectomy a 72-year-old man, complaining of abdominal pain and vomiting, presented to our emergency department. Ultrasound and computer tomography (CT) scans demonstrated a gallbladder-like structure with a 12-mm diameter stone and a subhepatic fluid collection. During an endoscopic retrograde cholangiopancreatography, a probably second gallbladder with a fistula of the posterior wall was filled with contrast. Laparoscopic exploration confirmed a missed gallbladder, which was successfully removed. Histologic diagnosis of cholecystolithiasis and chronic cholecystitis was made. The postoperative course was uneventful. Symptomatic double gallbladder should be considered also during the complicated postoperative course after the laparoscopic cholecystectomy and laparoscopic reoperation is feasible.
胆囊先天性重复是一种术前难以诊断的罕见疾病。一名72岁男性在腹腔镜胆囊切除术后8天,因腹痛和呕吐前来我院急诊科就诊。超声和计算机断层扫描(CT)显示一个类似胆囊的结构,内有一枚直径12毫米的结石以及肝下积液。在内镜逆行胰胆管造影术中,一个可能是第二个胆囊且后壁有瘘管的结构被造影剂充盈。腹腔镜探查证实存在一个漏诊的胆囊,并成功将其切除。做出了胆囊结石和慢性胆囊炎的组织学诊断。术后过程顺利。在腹腔镜胆囊切除术后的复杂术后过程中,也应考虑有症状的双胆囊,且腹腔镜再次手术是可行的。