Furuke Hirotaka, Takagi Tsuyoshi, Kobayashi Hiroki, Fukumoto Kanehisa
Department of Surgery, Nishijin Hospital, 1035 Mizomae-cho, Kamigyo-ku, Kyoto, 6028319, Japan.
Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Surg Case Rep. 2024 May 13;10(1):118. doi: 10.1186/s40792-024-01923-9.
Laparoscopic cholecystectomy (LC) is one of the most commonly undertaken procedures worldwide for cholecystolithiasis and cholecystitis. Accessory liver lobe (ALL) is a developmental anomaly defined as an excessive liver lobe composed of a normal liver parenchyma. Some ALL exist on the serosal side of the gallbladder. We herein present two cases of ALL incidentally detected during LC.
The first case was a 69-year-old woman diagnosed with chronic cholecystitis. LC was performed. ALL was observed anterior to the wall of the gallbladder and resected after clipping. Pathological findings revealed liver tissue with Glisson's capsule and a lobular structure in ALL. However, communication between the bile ducts of ALL and the main liver was unclear due to surgical heat degeneration. The second case was a 56-year-old woman diagnosed with acute cholecystitis. LC was performed approximately one month after the attack, and ALL attached to the wall of gallbladder. ALL was clipped and completely resected. Pathological findings showed that the bile ducts of ALL might be connected within the wall of gallbladder.
We presented two cases of ALL attached to the gallbladder encountered during LC. Since ALL contains a normal liver parenchyma, postoperative bleeding or bile leakage may occur if it is inefficiently resected. Therefore, the complete resection of ALL is important to prevent these postoperative complications.
腹腔镜胆囊切除术（LC）是全球范围内治疗胆囊结石和胆囊炎最常用的手术之一。副肝叶（ALL）是一种发育异常，定义为由正常肝实质组成的多余肝叶。一些ALL存在于胆囊的浆膜侧。我们在此报告两例在LC术中偶然发现的ALL病例。
第一例是一名69岁女性，诊断为慢性胆囊炎，接受了LC手术。在胆囊壁前方观察到ALL，夹闭后切除。病理结果显示ALL中肝组织有Glisson囊和小叶结构。然而，由于手术热变性，ALL胆管与主肝之间的连通情况尚不清楚。第二例是一名56岁女性，诊断为急性胆囊炎，在发作约1个月后接受了LC手术，ALL附着于胆囊壁。ALL被夹闭并完全切除。病理结果显示ALL胆管可能在胆囊壁内相连。
我们报告了两例在LC术中遇到的附着于胆囊的ALL病例。由于ALL包含正常肝实质，如果切除不彻底，术后可能发生出血或胆漏。因此，完整切除ALL对于预防这些术后并发症很重要。
