Šnajdr M, Chrastil L, Dvořák J
Rozhl Chir. 2013 Dec;92(12):722-5.
Congenital anomalies of the gallbladder, the biliary tract and their vasculature are relatively common. They usually represent only anatomical variations that may not manifest clinically, but in some cases they are of fundamental importance for the surgeon as they can cause diagnostic confusion or lead to problems during surgery. Their ignorance may result in many errors, injury during surgery and subsequent serious consequences. Genuine duplication of the gallbladder with the cystic duct and its artery is extremely rare and is therefore still only a subject of case reports. Gallbladder duplication itself is not an indication for surgery. If it contains stones or if inflammation occurs, however, both gallbladders may not be affected equally and if this variety is not recognized, only one of them may be removed and the other one can escape attention. The case report describes the rare case of gallbladder duplication including the cystic duct during elective cholecystectomy in a middle-aged man who was operated on after birth for omphalocele. Preoperative diagnostic examination described malrotation of the intestine and a cystic lesion next to the gallbladder, considered to be rather a liver cyst. Although it was indeed possible to assume various other abnormalities in the anatomical arrangement of the organs with regard to the patients history, the finding of double gallbladder including cystic duct was still surprising.
胆囊、胆道及其脉管系统的先天性异常较为常见。它们通常仅表现为解剖变异,可能无临床症状,但在某些情况下,对于外科医生而言却至关重要,因为它们可能导致诊断混淆或在手术过程中引发问题。对其忽视可能导致诸多失误、手术中的损伤及后续严重后果。真正的胆囊伴胆囊管及其动脉重复极为罕见,因此目前仍仅是病例报告的主题。胆囊重复本身并非手术指征。然而,如果胆囊内有结石或发生炎症,两个胆囊受影响的程度可能并不相同,若未识别出这种情况,可能仅切除其中一个胆囊,而另一个则会被忽视。该病例报告描述了一名中年男性在择期胆囊切除术中罕见的胆囊伴胆囊管重复病例,该男性出生后因脐膨出接受过手术。术前诊断检查显示肠道旋转不良以及胆囊旁有一个囊性病变,当时认为很可能是肝囊肿。尽管鉴于患者病史确实可以推测器官解剖结构存在其他各种异常,但发现双胆囊伴胆囊管的情况仍然令人惊讶。