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双叶胆囊:腹腔镜胆囊切除术中发现的一种罕见解剖变异

Bilobed Gallbladder: A Rare Anatomical Variation Discovered During Laparoscopic Cholecystectomy.

作者信息

Arza Alexis, Stitzlein Erin, Jen Jeremy, Park Jin Y, Ramachandra Prashanth

机构信息

Department of Surgery, Drexel University College of Medicine, Philadelphia, USA.

Department of General Surgery, Mercy Fitzgerald Hospital, Darby, USA.

出版信息

Cureus. 2024 Oct 24;16(10):e72300. doi: 10.7759/cureus.72300. eCollection 2024 Oct.

Abstract

A bilobed gallbladder is a rare congenital anomaly with two lobes sharing a single cystic duct, typically diagnosed preoperatively and rarely identified intraoperatively. Only a small number of cases have been documented in medical literature with limited information on associated conditions. A 22-year-old male patient, with a past medical history of cholelithiasis and no prior surgical history, presented with acute right upper quadrant pain and was diagnosed with acute cholecystitis. Initial ultrasound and magnetic resonance cholangiopancreatography imaging showed a distended gallbladder with multiple stones, but the bilobed gallbladder was only discovered during laparoscopic cholecystectomy, with an intraoperative retrospective imaging review confirming the diagnosis. This anatomical variation can complicate surgery, particularly in achieving the critical view of safety. In this case, a dome-down approach was used to complete laparoscopic cholecystectomy without intraoperative or postoperative issues. Early and accurate diagnosis is challenging but crucial for successful management. In this report, we present our surgical approach to managing this patient. This report aims to contribute to the limited literature on bilobed gallbladders.

摘要

双叶胆囊是一种罕见的先天性异常,有两个叶共享一条胆囊管,通常在术前诊断,很少在术中发现。医学文献中仅记录了少数病例,关于相关情况的信息有限。一名22岁男性患者,有胆石症病史,无既往手术史,因急性右上腹疼痛就诊,被诊断为急性胆囊炎。最初的超声和磁共振胰胆管造影成像显示胆囊扩张并伴有多个结石,但双叶胆囊仅在腹腔镜胆囊切除术中发现,术中回顾性成像检查证实了诊断。这种解剖变异会使手术复杂化,尤其是在实现关键安全视野方面。在本病例中,采用了自上向下的方法完成腹腔镜胆囊切除术,术中及术后均无问题。早期准确诊断具有挑战性,但对成功治疗至关重要。在本报告中,我们介绍了治疗该患者的手术方法。本报告旨在为关于双叶胆囊的有限文献做出贡献。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d0d/11500762/998827f4b271/cureus-0016-00000072300-i01.jpg

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