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全内脏转位患者的腹腔镜胆囊切除术:技术挑战与调整回顾

Laparoscopic cholecystectomy in a case of situs inversus totalis: a review of technical challenges and adaptations.

作者信息

Alam Azhar, Santra Abhijit

机构信息

Department of Surgery, B.R. Singh Hospital and Centre for Medical Education and Research, Eastern Railways, Kolkata, West Bengal, India.

出版信息

Ann Hepatobiliary Pancreat Surg. 2017 May;21(2):84-87. doi: 10.14701/ahbps.2017.21.2.84. Epub 2017 May 23.

Abstract

Situs inversus totalis is a rare congenital condition, characterized by the transposition of the thoracic and abdominal viscera, resulting in a mirror image of normal anatomy. Even though situs inversus does not predispose to gall stones, a laparoscopic cholecystectomy, in a case of situs inversus, can prove to be a technically challenging procedure, especially for the right-handed surgeon. In this case report, we present an unusual case of cholelithiasis in a patient with situs inversus totalis. A laparoscopic cholecystectomy, which is considered the gold standard procedure for symptomatic gallstones, was performed. The technical challenges that were anticipated due to anatomical anomalies were managed by various preoperative and intraoperative modifications. Through this present case report, we concluded that a laparoscopic cholecystectomy is a feasible and safe procedure in patients with situs inversus totalis and can be precisely performed by a right-handed surgeon, with necessary adaptations.

摘要

全内脏反位是一种罕见的先天性疾病,其特征是胸腹部脏器转位,形成正常解剖结构的镜像。尽管内脏反位不会增加胆结石的易感性,但对于内脏反位患者,腹腔镜胆囊切除术在技术上可能具有挑战性,尤其是对于右利手外科医生而言。在本病例报告中,我们呈现了一例全内脏反位患者患胆石症的罕见病例。我们实施了被认为是有症状胆结石的金标准手术——腹腔镜胆囊切除术。通过术前和术中的各种调整,应对了因解剖异常而预期出现的技术挑战。通过本病例报告,我们得出结论,腹腔镜胆囊切除术对于全内脏反位患者是一种可行且安全的手术,右利手外科医生在进行必要调整后可以精确实施该手术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b002/5449369/c704fed74a31/ahbps-21-84-g001.jpg

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