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全内脏转位患者的三孔腹腔镜胆囊切除术:一例报告

Three-port laparoscopic cholecystectomy in situs inversus totalis: A case report.

作者信息

Zhou Hai-Tao, Chen Jie, Huang Rui-Da, Wang Li-Meng, Zhou Jian-Chun

机构信息

Department of Hepatobiliary & Pancreatic Surgery, Yuyao People's Hospital, Ningbo, China.

出版信息

Medicine (Baltimore). 2025 Jul 4;104(27):e43186. doi: 10.1097/MD.0000000000043186.

Abstract

RATIONALE

Situs inversus totalis (SIT), a congenital anomaly characterized by the mirror-image inversion of thoracic and abdominal viscera, necessitates a cautious approach in the diagnosis and treatment of patients presenting with symptomatic cholelithiasis. Laparoscopic cholecystectomy, the preferred procedure for gallbladder removal in SIT patients, achieves favorable outcomes through thorough preoperative planning, a deep understanding of anatomy, and intraoperative adaptability.

PATIENT CONCERNS

Herein, we present the case of a 51-year-old female patient in SIT who underwent a laparoscopic cholecystectomy without complications due to choledocholithiasis and gallbladder stones.

DIAGNOSIS

Gallbladder stone; SIT.

INTERVENTIONS

laparoscopic cholecystectomy.

OUTCOMES

No complications such as bleeding or bile leakage (after LC) was detected. The patient was discharged after 2 days and recovered well after 1-year follow-up.

LESSONS

Thorough preoperative surgical planning, a deep understanding of anatomy, and the ability to adapt flexibly during surgery are key to the success of the operation.

摘要

原理

全内脏反位(SIT)是一种先天性异常,其特征为胸腹部脏器呈镜像反转,对于出现症状性胆石症的患者进行诊断和治疗时需要谨慎对待。腹腔镜胆囊切除术是SIT患者胆囊切除的首选手术,通过全面的术前规划、对解剖结构的深入了解以及术中的适应性操作可取得良好效果。

患者情况

在此,我们报告一例51岁全内脏反位女性患者,因胆总管结石和胆囊结石接受腹腔镜胆囊切除术,未发生并发症。

诊断

胆囊结石;全内脏反位。

干预措施

腹腔镜胆囊切除术。

结果

未检测到出血或胆漏(腹腔镜胆囊切除术后)等并发症。患者术后2天出院,1年随访后恢复良好。

经验教训

全面的术前手术规划、对解剖结构的深入了解以及手术中灵活应变的能力是手术成功的关键。

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