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术前诊断为双胆囊管并经腹腔镜胆囊切除术成功治疗:一例报告。

Double cystic duct preoperatively diagnosed and successfully treated with laparoscopic cholecystectomy: A case report.

作者信息

Fujii Atsushi, Hiraki Masatsugu, Egawa Noriyuki, Kono Hiroshi, Ide Takao, Nojiri Junichi, Ueda Junji, Irie Hiroyuki, Noshiro Hirokazu

机构信息

Department of Surgery, Faculty of Medicine, Saga University, Japan.

Department of Radiology, Faculty of Medicine, Saga University, Japan.

出版信息

Int J Surg Case Rep. 2017;37:102-105. doi: 10.1016/j.ijscr.2017.06.013. Epub 2017 Jun 13.

Abstract

INTRODUCTION

A single gallbladder with a double cystic duct is a very rare finding. In addition, few cases with this rare condition are preoperatively diagnosed. However, the preoperative confirmation or suspicion of this rare condition could facilitate safe laparoscopic cholecystectomy, which is a minimally invasive therapeutic modality for gallbladder disease. We herein present a case of gallstone disease in a patient with a double cystic duct who was preoperatively diagnosed and successfully treated with laparoscopic cholecystectomy.

PRESENTATION OF CASE

A 57-year-old woman was admitted to our hospital with epigastric pain. Gallstone disease in the gallbladder and common bile duct was diagnosed by ultrasonography and computed tomography. Magnetic resonance cholangiopancreatography (MRCP) and endoscopic retrograde cholangiography (ERC) revealed that the aberrant cystic duct arose from the cystic duct and communicated with the intrahepatic bile duct of the posterior segmental branch. Laparoscopic cholecystectomy was successfully performed in combination with intraoperative cholangiography.

DISCUSSION

If an anomaly of the biliary duct system is not identified during surgery, it may turn out to be a bile leak. The preoperative diagnosis of a double cystic duct allows laparoscopic cholecystectomy to be performed safely in combination with intraoperative cholangiography.

CONCLUSIONS

A single gallbladder with double cystic duct is a very rare anomaly. However, laparoscopic surgery can be facilitated by the use of preoperative and intraoperative images.

摘要

引言

单个胆囊伴有双胆囊管是一种非常罕见的情况。此外,术前诊断出这种罕见病症的病例很少。然而,术前对这种罕见病症的确认或怀疑有助于安全地进行腹腔镜胆囊切除术,这是一种治疗胆囊疾病的微创治疗方式。我们在此报告一例双胆囊管患者的胆结石疾病,该患者术前得到诊断并通过腹腔镜胆囊切除术成功治疗。

病例介绍

一名57岁女性因上腹部疼痛入院。通过超声检查和计算机断层扫描诊断出胆囊和胆总管患有胆结石疾病。磁共振胆胰管造影(MRCP)和内镜逆行胰胆管造影(ERC)显示,异常胆囊管起源于胆囊管并与后段分支的肝内胆管相通。联合术中胆管造影成功进行了腹腔镜胆囊切除术。

讨论

如果在手术过程中未识别出胆管系统异常,可能会导致胆漏。双胆囊管的术前诊断允许在联合术中胆管造影的情况下安全地进行腹腔镜胆囊切除术。

结论

单个胆囊伴有双胆囊管是一种非常罕见的异常情况。然而,术前和术中图像的使用有助于腹腔镜手术的进行。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/79ef/5485761/10ed23f779ef/gr1.jpg

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