Sun Hai-Jian, Ge Fei, Si Yue, Wang Zheng, Sun Hai-Bo
Department of General Surgery, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, Jiangsu Province, China.
Department of Gastroenterology, Haian Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, Nantong 226600, Jiangsu Province, China.
World J Clin Cases. 2023 Oct 6;11(28):6864-6870. doi: 10.12998/wjcc.v11.i28.6864.
Congenital agenesis of the gallbladder (CAGB) is a rare condition often misdiagnosed as cholecystolithiasis, leading to unnecessary surgeries. Accurate diagnosis and surgical exploration are crucial in patients with suspected CAGB or atypical gallbladder stone symptoms. Preoperative imaging, such as magnetic resonance cholangiopancreatography (MRCP), plays a vital role in confirming the diagnosis. Careful intraoperative dissection is necessary to avoid iatrogenic injuries and misdiagnosis. Multidisciplinary consultations and collaboration, along with the use of various diagnostic methods, can minimize associated risks.
We present the case of a 34-year-old female with suspected gallbladder stones, ultimately diagnosed with CAGB through surgical exploration. The patient underwent laparoscopic examination followed by open exploratory surgery, which confirmed absence of the gallbladder. Subsequent imaging studies supported the diagnosis. The patient received appropriate postoperative care and experienced a successful recovery.
This case highlights the rarity of CAGB and the importance of considering this condition in the differential diagnosis of patients with gallbladder stone symptoms. Accurate diagnosis using preoperative imaging, such as MRCP, is crucial to prevent unnecessary surgeries. Surgeons should exercise caution and conduct meticulous dissection during surgery to avoid iatrogenic injuries and ensure accurate diagnosis. Multidisciplinary collaboration and utilization of various diagnostic methods are essential to minimize the risk of misdiagnosis. Selection of the optimal treatment strategy should prioritize minimizing trauma and maintaining open communication with the patient and their family members.
先天性胆囊缺如(CAGB)是一种罕见病症,常被误诊为胆囊结石,导致不必要的手术。对于疑似CAGB或有非典型胆囊结石症状的患者,准确诊断和手术探查至关重要。术前影像学检查,如磁共振胰胆管造影(MRCP),在确诊中起着至关重要的作用。术中仔细解剖以避免医源性损伤和误诊。多学科会诊与协作,以及使用各种诊断方法,可将相关风险降至最低。
我们报告一例34岁疑似胆囊结石的女性病例,最终通过手术探查诊断为CAGB。患者先接受了腹腔镜检查,随后进行了开腹探查手术,术中证实胆囊缺如。后续影像学检查支持了这一诊断。患者术后接受了适当护理,恢复良好。
本病例凸显了CAGB的罕见性以及在胆囊结石症状患者鉴别诊断中考虑该病的重要性。使用术前影像学检查如MRCP进行准确诊断对于预防不必要的手术至关重要。外科医生在手术过程中应谨慎操作并进行细致解剖,以避免医源性损伤并确保准确诊断。多学科协作以及运用各种诊断方法对于将误诊风险降至最低至关重要。选择最佳治疗策略应优先考虑将创伤降至最低,并与患者及其家属保持开放沟通。