Cawich Shamir O, Wilson Carlos, Simpson Lindberg K, Baker Akil J
Department of Clinical Surgical Sciences, University of the West Indies, St. Augustine, Trinidad and Tobago.
Department of Surgery, Percy Junor Hospital, Spalding, Jamaica.
Case Rep Med. 2014;2014:787631. doi: 10.1155/2014/787631. Epub 2014 Aug 21.
Introduction. Stump cholecystitis is a recognised condition in which a large gallbladder remnant becomes inflamed after subtotal cholecystectomy. When this occurs, a completion cholecystectomy is indicated. Traditionally, these patients were subjected to open surgery because the laparoscopic approach was anticipated to be technically difficult. We present a case of completion cholecystectomy using basic laparoscopic equipment in a resource poor setting to demonstrate that the laparoscopic approach is feasible. Case Description. A 57-year-old woman presented with right upper quadrant pain and vomiting. She had an elective open cholecystectomy seven years before but reported remarkably similar symptoms. Abdominal ultrasound suggested calculous acute cholecystitis. MRCP confirmed the presence of a large gallbladder remnant with stones. Gastroduodenoscopy excluded other differentials. She had an uneventful laparoscopic completion cholecystectomy performed. Discussion. Although traditional dogma suggested that a completion cholecystectomy should be performed through the open approach, several small studies have demonstrated that laparoscopic completion cholecystectomy is feasible and safe. This report adds to the existing data in support of the laparoscopic approach.
引言。残端胆囊炎是一种已被认识的疾病，即胆囊次全切除术后大的胆囊残端发生炎症。当出现这种情况时，需行胆囊全切除术。传统上，这些患者需接受开放手术，因为预计腹腔镜手术在技术上会有困难。我们报告一例在资源匮乏地区使用基本腹腔镜设备进行胆囊全切除术的病例，以证明腹腔镜手术方法是可行的。病例描述。一名57岁女性因右上腹疼痛和呕吐就诊。她7年前接受了择期开放胆囊切除术，但现报告有明显相似症状。腹部超声提示结石性急性胆囊炎。磁共振胰胆管造影（MRCP）证实存在有结石的大胆囊残端。胃镜检查排除了其他鉴别诊断。她接受了顺利的腹腔镜胆囊全切除术。讨论。尽管传统观念认为胆囊全切除术应通过开放手术进行，但一些小型研究表明腹腔镜胆囊全切除术是可行且安全的。本报告补充了支持腹腔镜手术方法的现有数据。
