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腹腔镜胆囊切除术后低度囊性导管残端发育异常的病例及管理考量

Case and Management Considerations of Low-Grade Cystic Duct Stump Dysplasia after Laparoscopic Cholecystectomy.

作者信息

Ufongene Claire, Kunaprayoon Saran, Mestre Juan

机构信息

Icahn School of Medicine at Mount Sinai, New York, USA.

Mount Sinai Hospital, New York, USA.

出版信息

Case Rep Surg. 2024 Mar 7;2024:6682520. doi: 10.1155/2024/6682520. eCollection 2024.

Abstract

Cholecystectomies have become one of the more commonly practiced procedures. As a result, there has been a rise in neoplastic changes in excised specimens. Due to this, surgeons must be prepared to manage possible malignancy after resecting what was previously thought to be a benign gallbladder. While management for high-grade dysplasia has been more clearly laid out in literature, data on management of low-grade dysplasia are limited. Here, we report a novel case of a 46-year-old woman with an incidental low-grade dysplasia of the cystic duct stump after a laparoscopic cholecystectomy for biliary colic. The decision was made to excise the remaining stump without further surveillance postoperatively given benign pathology findings. More documented cases and their management and ultimately longitudinal cohort studies will help facilitate the creation of guidelines for managing this particular pathology.

摘要

胆囊切除术已成为较为常见的手术之一。因此,切除标本中的肿瘤性改变有所增加。正因如此,外科医生在切除此前认为是良性的胆囊后,必须做好处理可能出现的恶性病变的准备。虽然关于高级别发育异常的处理在文献中有更明确的阐述,但关于低级别发育异常处理的数据有限。在此,我们报告一例新病例,一名46岁女性因胆绞痛接受腹腔镜胆囊切除术后,其胆囊管残端意外出现低级别发育异常。鉴于病理检查结果为良性,决定切除剩余残端,术后不再进行进一步监测。更多有记录的病例及其处理方法,以及最终的纵向队列研究将有助于制定针对这种特殊病理情况的管理指南。

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引用本文的文献

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Int J Surg Case Rep. 2025 Jan;126:110650. doi: 10.1016/j.ijscr.2024.110650. Epub 2024 Nov 23.

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