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最长胆囊:一例报告。

Longest gallbladder: A case report.

作者信息

Yadav Rahul, Kankaria Jeevan

机构信息

Department of General Surgery, SMS Medical College and Hospital, JLN Marg, Jaipur, 302004 Rajasthan, India.

出版信息

Int J Surg Case Rep. 2017;33:127-129. doi: 10.1016/j.ijscr.2017.02.024. Epub 2017 Feb 28.

Abstract

INTRODUCTION

A gallbladder mucocele is the distention of the gallbladder by an inappropriate accumulation of mucus. Decreased bile flow, decreased gallbladder motility, and altered absorption of water from the gallbladder lumen are predisposing factors to biliary sludge. However, it is more likely to be a small part of a complex disease process involving inflammation of the gallbladder wall and changes to the lining of the gallbladder changing the consistency of its secretions. We would like to present a case of mucocele gallbladder operated successfully by laparoscopic cholecystectomy.

CASE REPORT

Herein, we present a case of 46year old female presenting with symptoms of pain in right hypochondrium with ultrasonographic diagnosis of cholelithiasis undergone successful laparoscopic cholecystectomy with Intraoperative findings of: 1. The length of the gallbladder was measured to be 30cm. 2. A large stone was impacted at the neck of gallbladder, which was leading to mucocele formation.

CONCLUSION

Mucocele of gallbladder present an important hurdle in successful laparoscopic cholecystectomy. A habit of calm and slow dissection with precautions should be developed. Clearance of the calot's triangle with limited use of electro cautery should be done before proceeding towards ligation or clip application to various structures.

摘要

引言

胆囊黏液囊肿是由于黏液不适当积聚导致胆囊扩张。胆汁流动减少、胆囊动力下降以及胆囊腔内水吸收改变是胆泥形成的诱发因素。然而,它更可能是涉及胆囊壁炎症和胆囊内衬变化从而改变其分泌物黏稠度的复杂疾病过程的一小部分。我们想介绍一例通过腹腔镜胆囊切除术成功治疗的胆囊黏液囊肿病例。

病例报告

在此,我们呈现一例46岁女性,因右季肋部疼痛症状就诊,超声诊断为胆结石,成功接受了腹腔镜胆囊切除术,术中发现如下:1. 胆囊长度测量为30厘米。2. 一枚大结石嵌顿于胆囊颈部,导致黏液囊肿形成。

结论

胆囊黏液囊肿是成功进行腹腔镜胆囊切除术的一个重要障碍。应养成谨慎、缓慢且冷静的解剖习惯。在对各种结构进行结扎或夹闭操作之前,应在有限使用电灼的情况下清理胆囊三角。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e45/5358904/ffd5f138deff/gr1.jpg

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