Adon Auguste Alexandre, Goho Marius Kouidé, Ahue Kouassi Henry Noel, Aboua Gustave, Coulibaly Ngolo Adama, Kpan Kunka Jocelyne
Felix Houphouët Boigny University Abidjan Côte d'Ivoire, Medical School Education and Research Unit, 01 BPV34 Abidjan 01, Côte d'Ivoire; General, Digestive and Endocrine Surgery Department of Treichville Teaching Hospital, 01 BP V3 Abidjan 01, Côte d'Ivoire.
Felix Houphouët Boigny University Abidjan Côte d'Ivoire, Medical School Education and Research Unit, 01 BPV34 Abidjan 01, Côte d'Ivoire; General, Digestive and Endocrine Surgery Department of Treichville Teaching Hospital, 01 BP V3 Abidjan 01, Côte d'Ivoire; Surgical Emergency Department of Treichville Teaching Hospital, 01 BP V3 Abidjan 01, Côte d'Ivoire.
Int J Surg Case Rep. 2025 May;130:111274. doi: 10.1016/j.ijscr.2025.111274. Epub 2025 Apr 9.
The intrahepatic location of the gallbladder is one of the most common ectopic locations of the gallbladder. An intrahepatic gallbladder often exhibits impaired function, which may lead to stasis and gallstone formation. Given the surgical complexities associated with this ectopic location, the traditional open approach is usually employed.
The authors report the case of a 52-year-old female patient who consulted for pain in the right hypochondrium. Physical examination revealed only right upper quadrant pain on palpation. Abdominal ultrasound revealed gallbladder lithiasis without indicating the presence of an anatomical anomaly. A laparoscopic cholecystectomy was performed in the "French position" with 4 trocars. During surgery, we discovered an intrahepatic gallbladder. Subserosal dissection of the gallbladder was done without having to perform a hepatotomy. The patient was discharged on postoperative day 2 without any complications.
Intra hepatic location of gallbladder is rare and can be detected by ultrasound or CT scan but in our study, it has not been detected by ultrasound before operation. Laparoscopic approach for a gallstone within ectopic gallbladder is rarely described in literature because cholecystectomy by conventional route is preferred when this anomaly is known and mostly when gallbladder is completely embedded within the liver.
Laparoscopic cholecystectomy remains the gold standard for a partial intrahepatic gallbladder.
胆囊位于肝内是胆囊最常见的异位位置之一。肝内胆囊常表现出功能受损，这可能导致胆汁淤积和胆结石形成。鉴于与这种异位位置相关的手术复杂性，通常采用传统的开放手术方法。
作者报告了一例52岁女性患者，因右季肋部疼痛前来就诊。体格检查仅发现触诊时右上腹疼痛。腹部超声显示胆囊结石，但未提示存在解剖异常。采用“法国体位”，通过4个套管针进行了腹腔镜胆囊切除术。手术过程中，我们发现了一个肝内胆囊。在未进行肝切开术的情况下，对胆囊进行了浆膜下剥离。患者术后第2天出院，无任何并发症。
胆囊位于肝内的情况罕见，可通过超声或CT扫描检测到，但在我们的研究中，术前超声未检测到。文献中很少描述对异位胆囊内胆结石采用腹腔镜手术方法，因为当已知这种异常情况时，尤其是当胆囊完全包埋在肝脏内时，通常首选传统途径进行胆囊切除术。
腹腔镜胆囊切除术仍然是部分肝内胆囊手术的金标准。
