Horattas M C
Akron General Medical Center, Northeastern Ohio Universities College of Medicine, USA.
J Laparoendosc Adv Surg Tech A. 1998 Aug;8(4):231-5. doi: 10.1089/lap.1998.8.231.
Gallbladder duplication can present a significant challenge to the laparoscopic surgeon, primarily due to difficulties with diagnosis and recognition. Previous reports of attempted laparoscopic cholecystectomy in patients with gallbladder duplication resulted in incomplete or staged multiple procedures. The case report of a 35-year-old woman with successful laparoscopic management of symptomatic gallbladder duplication is described, emphasizing several important considerations. Preoperatively when evaluating radiologic studies a high index of suspicion is necessary in interpreting atypical findings. To further evaluate these abnormalities, liberal use of preoperative ERCP is helpful, and specific endoscopic techniques may be necessary as well. Intraoperatively, the findings may be confusing, and cholangiography can help clarify ductular anomalies, especially if the gallbladder duplication is contained within a common serosal coat. Missing a second gallbladder can result in persistent symptoms postoperatively necessitating further surgery. Laparoscopic cholecystectomy in the management of gallbladder duplication can be safely done and an awareness is necessary to avoid complications or multiple procedures.
胆囊重复畸形会给腹腔镜外科医生带来重大挑战，主要是因为诊断和识别存在困难。先前关于对胆囊重复畸形患者尝试进行腹腔镜胆囊切除术的报告显示，手术往往不完整或需要分阶段进行多次操作。本文描述了一例35岁女性成功接受腹腔镜治疗有症状胆囊重复畸形的病例报告，并强调了几个重要的注意事项。术前评估影像学检查时，在解读非典型表现时需要高度怀疑。为了进一步评估这些异常情况，术前应广泛使用内镜逆行胰胆管造影（ERCP），可能还需要特定的内镜技术。术中，所见情况可能令人困惑，胆管造影有助于明确胆管异常，特别是当胆囊重复畸形位于共同浆膜层内时。遗漏第二个胆囊可能导致术后持续出现症状，从而需要进一步手术。腹腔镜胆囊切除术可安全地用于治疗胆囊重复畸形，必须提高认识以避免并发症或多次手术。
