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腹腔镜胆囊切除术后胆囊内的异位胰腺组织:一例罕见病例

Ectopic Pancreatic Tissue in the Gallbladder Following Laparoscopic Cholecystectomy: A Rare Case.

作者信息

Turhan Mustafa Anil, Akin Furkan Atakan, Yasaran Benk Zumrut Merve

机构信息

Transplant, Memorial Ankara Hospital, Ankara, TUR.

General Surgery, Yildirim Beyazit University Yenimahalle Training and Research Hospital, Ankara, TUR.

出版信息

Cureus. 2025 Feb 22;17(2):e79445. doi: 10.7759/cureus.79445. eCollection 2025 Feb.

Abstract

Ectopic pancreatic tissue (EPT) is a rare clinical condition characterized by the presence of pancreatic tissue without any anatomical or vascular connection to the main pancreas. We aim to present a highly unusual case of EPT (fewer than 40 reported cases in the literature), located in the wall of the gallbladder. A 41-year-old female presented with episodes of right upper quadrant and epigastric pain, nausea, and vomiting. Diagnostic imaging revealed multiple gallstones, with the largest measuring 12 mm. The gallbladder wall was normal in thickness, and there were no abnormalities in the liver, bile ducts, spleen, or pancreas. Laboratory tests were normal, except for iron-deficiency anemia. Amylase and lipase levels were within normal limits. The patient underwent an uncomplicated elective laparoscopic cholecystectomy. Pathological examination of the gallbladder revealed chronic cholecystitis and EPT classified as type 3 EPT according to the Gaspar Fuentes classification. Due to its various clinical presentations and the low discriminative power of routine imaging tests, preoperative diagnosis of EPT is nearly impossible. However, considering the potential for malignant transformation and complications of EPT, physicians should be aware of this clinical entity and consider cholecystectomy when there is a high degree of suspicion. EPT in the gallbladder is an extremely rare finding. Patients are either asymptomatic or present with nonspecific symptoms, and the definitive diagnosis is almost always made through pathological examination following cholecystectomy.

摘要

异位胰腺组织(EPT)是一种罕见的临床病症,其特征是存在与主胰腺无任何解剖或血管连接的胰腺组织。我们旨在呈现一例非常罕见的位于胆囊壁的EPT病例(文献报道病例少于40例)。一名41岁女性出现右上腹和上腹部疼痛、恶心及呕吐症状。诊断性影像学检查发现多个胆结石,最大的直径为12毫米。胆囊壁厚度正常,肝脏、胆管、脾脏或胰腺均无异常。实验室检查除缺铁性贫血外均正常。淀粉酶和脂肪酶水平在正常范围内。该患者接受了一次无并发症的择期腹腔镜胆囊切除术。胆囊的病理检查显示为慢性胆囊炎,且根据加斯帕尔·富恩特斯分类法,EPT被归类为3型EPT。由于其临床表现多样且常规影像学检查的鉴别能力较低,术前几乎不可能诊断出EPT。然而,考虑到EPT有恶变和并发症的可能性,医生应了解这一临床实体,在高度怀疑时考虑行胆囊切除术。胆囊中的EPT是一种极其罕见的发现。患者要么无症状,要么表现出非特异性症状,几乎总是在胆囊切除术后通过病理检查才能做出明确诊断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f5a/11846051/d64f2a3fcec1/cureus-0017-00000079445-i01.jpg

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