Sinistroposition of the gallbladder and common bile duct.
Sinistroposition of the gallbladder and common bile duct.
复制标题
胆囊和胆总管的左位。
DOI：
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复制
发表时间：
2005
期刊：
影响因子：
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通讯作者：
Hong
中科院分区：
文献类型：
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作者：
B. Shen;J. Regimbeau;Hong
背景
尽管左侧胆囊症的发病率很低，但已经发表的病例很少。
方法
我们在此报告一位29岁的男性左肝肿瘤患者，强制行左半叶切除。这是首次描述为胆囊胆总管双端错位。
结果
手术探查发现左侧胆囊壁位于肝脏左叶下方。在圆韧带和Rex隐窝左侧肝实质剥离时，胆总管受到损伤。完全分离的肝蒂结构显示，在到达肝十二指肠韧带之前，上胆管汇聚通过了Rex隐窝的左侧。
结论
只有在肝实质切除前仔细解剖肝十二指肠韧带至Rex隐窝水平，才能避免左叶切除术中胆道损伤。
BACKGROUND
Despite its rare incidence, few cases of left-side gallbladder have been already published.
METHODS
We reported herein the case of a 29-year-old man with a left liver tumor in whom left lateral bisegmentectomy was mandatory. It represents the first description of a sinistroposition of both gallbladder and common bile duct.
RESULTS
Surgical exploration revealed a left-side gallbladder, located under the left lobe of the liver. During hepatic parenchyma dissection at the left side of the round ligament and the Rex recessus, the common bile duct was injured. Complete separation of hepatic pedicle structures showed that the upper biliary convergence passed on the left side of the Rex recessus before reaching the hepatoduodenal ligament.
CONCLUSION
Only careful dissection of the hepatoduodenal ligament up to Rex recessus level prior to liver parenchyma resection could avoid biliary tract injury during left lobectomy.