Gallbladder-associated ectopic liver: A rare finding during a laparoscopic cholecystectomy
Gallbladder-associated ectopic liver: A rare finding during a laparoscopic cholecystectomy
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DOI：
10.1016/j.ijscr.2013.01.006
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发表时间：
2013-01-01
影响因子：
0.6
通讯作者：
Palma, Rogerio Tadeu
中科院分区：
文献类型：
--
作者：
Martinez, Carlos Augusto Real;de Resende junior, Herminio Cabral;Palma, Rogerio Tadeu
简介：异位肝组织是一种罕见的胚胎肝发育失败，在世界医学文献中很少描述。据报道，异位肝（EL）的发生率在剖腹手术或腹腔镜检查中诊断为0.24%至0.47%。我们描述的情况下，EL粘附到胆囊，在腹腔镜cholecystectomy.Presentation的情况下删除：一名37岁的女性被录取为择期胆囊切除术有一个发作的急性胆囊炎引起的胆结石。在手术过程中，在腹腔镜胆囊切除术期间，识别并整块切除了附着在胆囊前壁的30 mm x 10 mm x 5 mm EL组织切片。组织学检查证实肝组织无恶性变性。患者术后恢复良好，并于术后第二天出院。讨论：EL已报告在几个网站，如胆囊，胃肝韧带，肾上腺，食管和胸腔。EL通常在临床上是无症状的，在腹部外科手术或尸检中偶然发现。由于异位肝患者可能会遭受并发症，如扭转，腹膜出血，脂肪变化，并演变为肝硬化或恶性变性肝细胞癌，任何异位肝组织需要正确识别和remove.CONCLUSION：尽管EL的罕见发生，它应该被认识到，并删除由外科医生，以防止并发症和恶性转化的风险较高。(C)2013 Surgical Associates Ltd.由Elsevier Ltd.出版。CC BY-NC-ND许可下开放访问。
INTRODUCTION: Ectopic hepatic tissue is due to an uncommon failure of embryological liver development that is rarely described in the world medical literature. The incidence of ectopic liver (EL) has been reported to be anywhere from 0.24% to 0.47% as diagnosed at laparotomy or laparoscopy. We describe a case of EL adherent to the gallbladder, removed at laparoscopic cholecystectomy.PRESENTATION OF CASE: A 37-year-old female was admitted for elective cholecystectomy having had an episode of acute cholecystitis provoked by gallstones. During the procedure, a 30 mm x10 mm x5 mm section of EL tissue attached to the anterior wall of the gallbladder was identified and removed by en-bloc excision during laparoscopic cholecystectomy. Histological examination confirmed the absence of malignant degeneration of the hepatic tissue. The patient recovered well postoperatively and was discharged the day after the operation. She was well when seen six months later.DISCUSSION: EL has been reported in several sites, such as the gallbladder, gastrohepatic ligament, adrenal glands, esophagus, and thoracic cavity. EL is often clinically silent and discovered incidentally during abdominal surgical procedures or autopsies. Because patients with ectopic liver may suffer complications such as torsion, peritoneal bleeding, fatty change, and evolution to cirrhosis or malignant degeneration to hepatocellular carcinoma, any ectopic liver tissue needs to be correctly identified and removed.CONCLUSION: Despite the rare occurrence of EL, it should be recognized and removed by the surgeon to prevent a higher risk of complications and malignant transformation. (C) 2013 Surgical Associates Ltd. Published by Elsevier Ltd. Open access under CC BY-NC-ND license.