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合并胆总管囊肿的巨大胆总管结石：1例罕见病例报告

Giant Choledocholithiasis With Choledochal Cyst: A Report of a Rare Case.

作者信息

V Vinay, S Kumar Nayana, Khan Ozair, Azharuddin S K

机构信息

Gastrointestinal Surgery, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND.

General Surgery, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND.

出版信息

Cureus. 2024 Jul 11;16(7):e64306. doi: 10.7759/cureus.64306. eCollection 2024 Jul.

DOI:10.7759/cureus.64306
PMID:39130959
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11316851/
Abstract

A giant common bile duct (CBD) calculus is a rare occurrence, and the presence of a giant calculus within a choledochal cyst (CDC) is even more unusual. In this case report, we detail an instance of a giant CBD calculus measuring 7 cm x 3 cm found within a CDC, accompanied by multiple tiny calculi. Magnetic resonance cholangiopancreatography (MRCP) revealed the dilation of the bi-lobar intrahepatic biliary radical (IHBR) and the CBD. A large T2 hypointense and T1 hyperintense calculus occupied the dilated CBD and common hepatic duct (CHD), extending into the left hepatic duct (LHD) and right hepatic duct (RHD). There was a possibility of type 1c CDC with cystolithiasis, hepatolithiasis, and cholelithiasis. The patient underwent open cholecystectomy with choledochotomy, stone retrieval, excision of the CDC, and Roux-en-Y hepaticojejunostomy.

摘要

巨大胆总管结石较为罕见，而胆总管囊肿（CDC）内出现巨大结石则更为少见。在本病例报告中，我们详细介绍了一例在CDC内发现的大小为7 cm×3 cm的巨大胆总管结石病例，同时伴有多个微小结石。磁共振胆胰管造影（MRCP）显示双侧肝内胆管分支（IHBR）和胆总管扩张。一个大的T2低信号和T1高信号结石占据了扩张的胆总管和肝总管（CHD），延伸至左肝管（LHD）和右肝管（RHD）。存在1c型CDC合并胆囊结石、肝内胆管结石和胆结石的可能性。患者接受了开腹胆囊切除术、胆总管切开取石术、CDC切除术和Roux-en-Y肝空肠吻合术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/234f/11316851/793904eefef3/cureus-0016-00000064306-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/234f/11316851/b9e01bc5fa91/cureus-0016-00000064306-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/234f/11316851/0aa559da281a/cureus-0016-00000064306-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/234f/11316851/097f240e6132/cureus-0016-00000064306-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/234f/11316851/c1df03249738/cureus-0016-00000064306-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/234f/11316851/793904eefef3/cureus-0016-00000064306-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/234f/11316851/b9e01bc5fa91/cureus-0016-00000064306-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/234f/11316851/0aa559da281a/cureus-0016-00000064306-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/234f/11316851/097f240e6132/cureus-0016-00000064306-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/234f/11316851/c1df03249738/cureus-0016-00000064306-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/234f/11316851/793904eefef3/cureus-0016-00000064306-i05.jpg

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本文引用的文献

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Giant Calculus with More than 100 Small Calculi in Choledochal Cysts.胆总管囊肿内有超过100个小结石的巨大结石。
Case Rep Gastroenterol. 2021 Feb 26;15(1):244-252. doi: 10.1159/000513145. eCollection 2021 Jan-Apr.
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