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胆囊重复畸形

Gallbladder duplication.

作者信息

Pillay Yagan

机构信息

Department of General Surgery, Victoria Hospital, Prince Albert Parkland Health Region, Prince Albert S6V8C3, SK, Canada.

出版信息

Int J Surg Case Rep. 2015;11:18-20. doi: 10.1016/j.ijscr.2015.04.002. Epub 2015 Apr 11.

Abstract

INTRODUCTION

Gallbladder duplication is a rare congenital malformation that occurs in about one in 4000 births. Congenital anomalies of the gallbladder and anatomical variations of their positions are associated with an increased risk of complications after laparoscopic cholecystectomy.

PRESENTATION OF CASE

We report the case of a double gallbladder in a fifty-six year old man. He presented with recurrent episodes of biliary colic. Pre-operative imaging confirmed the diagnosis. He subsequently underwent surgery for biliary colic.

DISCUSSION

Inspection of the resected gallbladder specimen showed that it consisted of two chambers with a single cystic duct, which communicated through a common ostium. Both chambers had cholelithiasis. There were two cystic arteries as well. Duplication of the gallbladder has an incidence of approximately 1: 4000. However, the exact incidence of this rare anomaly cannot be accurately assessed, since the only cases which have been identified are those that became symptomatic or were encountered as incidental findings during surgery, imaging studies or at autopsy.

CONCLUSION

Duplication of the gallbladder is a rare congenital abnormality, which requires special attention to the biliary ductal and arterial anatomy. Laparoscopic cholecystectomy with intraoperative cholangiography is the appropriate treatment in a symptomatic gallbladder. The removal of an asymptomatic double gallbladder remains controversial.

摘要

引言

胆囊重复是一种罕见的先天性畸形,发生率约为4000例出生中有1例。胆囊先天性异常及其位置的解剖变异与腹腔镜胆囊切除术后并发症风险增加相关。

病例介绍

我们报告一例56岁男性的双胆囊病例。他表现为反复发作的胆绞痛。术前影像学检查确诊。随后他因胆绞痛接受了手术。

讨论

对切除的胆囊标本检查显示,它由两个腔室组成,有一条单一的胆囊管,通过一个共同开口相通。两个腔室均有胆石症。还有两条胆囊动脉。胆囊重复的发生率约为1:4000。然而,这种罕见异常的确切发生率无法准确评估,因为已发现的唯一病例是那些出现症状的,或在手术、影像学检查或尸检时作为偶然发现的。

结论

胆囊重复是一种罕见的先天性异常,需要特别关注胆管和动脉解剖结构。对于有症状的胆囊,腹腔镜胆囊切除术加术中胆管造影是合适的治疗方法。无症状双胆囊的切除仍存在争议。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c86/4446663/521615a41b60/gr1.jpg

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