Ogawa T, Ohwada S, Ikeya T, Shiozaki H, Aiba S, Morishita Y
Department of Surgery, Maebashi Red Cross Hospital, Gunma, Japan.
Hepatogastroenterology. 1995 Sep-Oct;42(5):645-9.
A 66-year-old man was admitted for an early cancer in the gastric corpus. At laparotomy, the gallbladder was located on the left side of the round ligament and attached to the lateral segment of the liver. This finding was compatible with a left-sided gallbladder. Postoperative ultrasonograms and portograms demonstrated anomalies of the intrahepatic portal vein as follows; The left umbilical portion and the posterior point of the portal branch were lacking. The posterior point was seen as an umbilical portion. An endoscopic retrograde cholangiopancreaticogram showed the cystic duct entering into the right side of the common bile duct confluent to the accessory pancreatic duct. A left-sided gallbladder unassociated with visceral inversion is a rare congenital anomaly. Forty-one cases have been reported in Japan, five with anomalies of the intrahepatic portal vein and two with anomalous junction of the pancreaticobiliary ductal system. To our knowledge, our patient is the only case of the left-sided gallbladder which both congenital anomalies.
一名66岁男性因胃体早期癌入院。剖腹手术时,胆囊位于圆韧带左侧并附着于肝脏外侧段。这一发现符合左侧胆囊的表现。术后超声检查和门静脉造影显示肝内门静脉存在以下异常:左脐部和门静脉分支的后点缺失。后点被视为脐部。内镜逆行胰胆管造影显示胆囊管进入胆总管右侧并与副胰管汇合。不伴有内脏反位的左侧胆囊是一种罕见的先天性异常。日本已报道41例,其中5例伴有肝内门静脉异常,2例伴有胰胆管系统异常连接。据我们所知,我们的患者是左侧胆囊同时存在这两种先天性异常的唯一病例。