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腹腔镜评估及切除起源于右肝管的II型胆总管囊肿,该囊肿酷似胆囊重复畸形。

Laparoscopic evaluation and resection of type-II choledochal cyst arising from right hepatic duct mimicking gall bladder duplication.

作者信息

Bhojwani Rajesh, Jain Nikhil, Mishra Subhash

机构信息

Department of Surgical Gastroenterology, Santokba Institute of Digestive Surgical Sciences, Santokba Durlabhji Memorial Hospital Cum Research Institute, Jaipur, Rajasthan, India.

出版信息

J Minim Access Surg. 2019 Apr-Jun;15(2):158-160. doi: 10.4103/jmas.JMAS_101_18.

Abstract

A Type II choledochal cyst arising from the right hepatic duct may mimic a gall bladder duplication. Both are rare and may not get differentiated before operative exploration. While a magnetic resonance cholangiopancreatography (MRCP) may be helpful, laparoscopy may be the final tool for evaluation and effective surgical treatment. We report such a case of a 22-year-old male whose MRCP was suggestive of a cystic lesion in the gall bladder fossa and was taken up for surgery with a pre-operative diagnosis of gall bladder duplication with a single cystic duct. He underwent elective laparoscopic evaluation, mobilisation, discerning of anatomy and diagnosis, excision of cyst and concomitant cholecystectomy. This case highlights that these two rare entities can mimic each other on imaging; however, a laparoscopic approach serves the dual purpose of diagnosing and treating this unique pathoanatomical entity.

摘要

起源于右肝管的II型胆总管囊肿可能类似胆囊重复畸形。两者均罕见,在手术探查前可能无法鉴别。虽然磁共振胰胆管造影(MRCP)可能有帮助,但腹腔镜检查可能是评估和有效手术治疗的最终手段。我们报告了这样一例22岁男性病例,其MRCP提示胆囊窝有囊性病变,术前诊断为胆囊重复畸形伴单一胆囊管,遂接受手术。他接受了择期腹腔镜评估、游离、解剖结构辨别与诊断、囊肿切除及同期胆囊切除术。该病例强调这两种罕见病变在影像学上可能相互类似;然而,腹腔镜方法兼具诊断和治疗这种独特病理解剖实体的双重目的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9a73/6438057/9d0750453206/JMAS-15-158-g001.jpg

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