Department of Surgery, College of Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA.
J Surg Educ. 2013 Jan-Feb;70(1):117-20. doi: 10.1016/j.jsurg.2012.07.001. Epub 2012 Aug 14.
Congenital agenesis of the gallbladder and cystic duct represents a rare anomaly of the biliary system. It likely results from an embryologic mishap in the development of the hepatobiliary bud and can occur with other associated malformations. We report the case of congenital absence of the gallbladder and cystic duct incidentally found during laparoscopy in a 44-year-old Caucasian female. Based on the clinical presentation and ultrasonography findings, the patient was presumed to have symptomatic cholelithiasis and chronic cholecystitis. A laparoscopic cholecystectomy was planned. After introducing the laparoscope, the gallbladder and cystic duct were absent and the procedure aborted. Gallbladder and cystic duct agenesis was confirmed by magnetic resonance cholangiopancreatography. We describe here the difficulties with diagnosis and pain management, and review the literature of this rare pathology.
先天性胆囊和胆囊管发育不全是胆道系统罕见的异常。它可能是肝芽发育过程中的胚胎发育错误引起的,并且可能与其他相关畸形同时发生。我们报告了一例 44 岁白人女性在腹腔镜检查中偶然发现的先天性胆囊和胆囊管缺失。基于临床表现和超声检查结果,该患者被推测患有有症状的胆石症和慢性胆囊炎。计划进行腹腔镜胆囊切除术。在引入腹腔镜后,发现胆囊和胆囊管缺失,手术中止。磁共振胰胆管成像证实了胆囊和胆囊管缺失。我们在这里描述了诊断和疼痛管理的困难,并回顾了这种罕见病理的文献。