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在无内脏反位(“左位心”)情况下胆囊位于镰状韧带左侧——2例有此异常并接受迷你腹腔镜胆囊切除术患者的病例系列

Gallbladder to the left side of the falciform ligament in absence of Situs Inversus "Sinistroposition" - Case series of 2 patients with this anomaly who underwent mini-laparoscopic cholecystectomy.

作者信息

Mendoza-Calderón Carlos, Sotelo Jose William, Dávila-Arriaga Aldo Roberto

机构信息

Tenancingo Surgical Center (Central Quirúrgica Tenancingo), 306 Matamoros, Tenancingo, Mexico, 52400, Mexico.

出版信息

Int J Surg Case Rep. 2018;50:36-41. doi: 10.1016/j.ijscr.2018.05.031. Epub 2018 Jun 27.

Abstract

INTRODUCTION

Gallbladders located to the left of falciform ligament, without situs inversus, are denominated sinistroposition or true left-sided gallbladders; it is considered a rare anatomic anomaly with a prevalence in between 0.1% and 0.7%. Left-sided gallbladder usually occur as a component of situs inversus.

PRESENTATION OF CASES

We report a case series of two patients of true left-sided gallbladder that were found at our institution from 2015 to 2017; the anatomic anomalies were discovered during the performance of mini-laparoscopic cholecystectomy due to acute cholecystitis with cholelithiasis in both cases. Both patients underwent a successful surgery and there were no postsurgical complications.

DISCUSSION

The reported prevalence of left-sided gallbladder is between 0.1% and 0.7%, thus considered a rare anatomic finding. Currently, with advances in diagnostic imaging modalities, the report of left-sided gallbladder has increased nowadays. It may be a more common anomaly than previously thought.

CONCLUSION

True left-sided gallbladder can be an incidental finding; it is in part due to the fact that radiographic images do not typically detect this anomaly, therefore surgeons must be aware of this condition because it is associated with anomalies in the intrahepatic portal vein and biliary tree.

摘要

引言

位于镰状韧带左侧且无内脏反位的胆囊被称为左位胆囊或真正的左侧胆囊;这被认为是一种罕见的解剖学异常,患病率在0.1%至0.7%之间。左侧胆囊通常作为内脏反位的一部分出现。

病例展示

我们报告了2015年至2017年在我们机构发现的两例真正左侧胆囊患者的病例系列;两例均因急性胆囊炎伴胆结石在进行迷你腹腔镜胆囊切除术时发现解剖学异常。两名患者均手术成功,且无术后并发症。

讨论

报道的左侧胆囊患病率在0.1%至0.7%之间,因此被认为是一种罕见的解剖学发现。目前,随着诊断成像技术的进步,如今左侧胆囊的报告有所增加。它可能是一种比以前认为的更常见的异常。

结论

真正的左侧胆囊可能是偶然发现;部分原因是放射影像通常无法检测到这种异常,因此外科医生必须了解这种情况,因为它与肝内门静脉和胆管树的异常有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9ab/6072888/891ca9f4e593/gr1.jpg

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