Khalaf Mohamed H, Mohamed Lina M, Al-Zoubi Raed M, Zarour Ahmad, Ghali Mohamed Said
Department of Surgery, Acute Care Surgery Hamad Medical Corporation Doha Qatar.
Surgical Research Section, Department of Surgery Hamad Medical Corporation & Men's Health Doha Qatar.
Clin Case Rep. 2024 Oct 31;12(11):e9394. doi: 10.1002/ccr3.9394. eCollection 2024 Nov.
Vigilant intraoperative inspection is crucial during gallbladder surgery to detect any abnormal tissue including the rare pyloric gland adenomas, which can be easily missed. Thorough examination and removal of unusual lymph nodes or thickened tissues are essential to prevent the risk of malignant transformation and ensure comprehensive patient care.
Pyloric gland adenomas are uncommon tumors that can be discovered in various organs such as the stomach, gallbladder, and pancreas. Typically lacking noticeable symptoms, these tumors are categorized into subtypes, with the pyloric variant being the most frequent. The term "intracholecystic papillary-tubular neoplasms (ICPN)" is used to emphasize growth patterns and associated risks. In a discussed case, a detached pyloric gland adenoma was identified incidentally during a cholecystectomy procedure. A 58-year-old obese male presented with upper abdominal pain, nausea, and vomiting. He was diagnosed with early cholecystitis caused by gallstones. Subsequently, during a laparoscopic cholecystectomy, a detached adenoma was discovered. Vigilant screening is crucial, as the identification of gallbladder pyloric gland adenomas is a rare occurrence that might be missed during gallbladder surgery. Any unusual lymph nodes or thickened tissues found in association with the gallbladder ought to be carefully removed, as they could potentially indicate detached gallbladder adenomas with a significant risk of becoming malignant. Failing to consider this possibility may subject the patient to prolonged risks if not meticulously examined.
在胆囊手术中，术中进行警惕的检查对于发现任何异常组织（包括罕见的幽门腺腺瘤）至关重要，这些异常组织很容易被遗漏。彻底检查并切除异常的淋巴结或增厚组织对于预防恶性转化风险和确保全面的患者护理至关重要。
幽门腺腺瘤是一种罕见的肿瘤，可在胃、胆囊和胰腺等各种器官中发现。这些肿瘤通常没有明显症状，可分为不同亚型，其中幽门型最为常见。术语“胆囊内乳头管状肿瘤（ICPN）”用于强调生长模式和相关风险。在一个讨论的病例中，在胆囊切除术中偶然发现了一个游离的幽门腺腺瘤。一名58岁肥胖男性出现上腹部疼痛、恶心和呕吐。他被诊断为胆结石引起的早期胆囊炎。随后，在腹腔镜胆囊切除术中发现了一个游离的腺瘤。警惕的筛查至关重要，因为胆囊幽门腺腺瘤的识别很少见，可能在胆囊手术中被遗漏。与胆囊相关发现的任何异常淋巴结或增厚组织都应仔细切除，因为它们可能表明存在游离的胆囊腺瘤，有显著的恶变风险。如果不仔细检查而未考虑这种可能性，可能会使患者面临长期风险。
