左側胆嚢と胆管走向異常を伴う急性胆嚢炎に対して腹腔鏡下胆嚢摘出術を行った１例

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  • A Case of Laparoscbpic Cholecystectomy for Acute Cholecystitis associated with the Left-Sided Gallbladder and an Aberrant Hepatic Duct

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A 60 year-old man admitted for fever and epigastralgia was found in computed tomography to have a swollen gall bladder with a thickened wall located to the left of the umbilical portion and diagnosed as acute cholecystitis of the left-sided gall bladder. Direct cholangiography showed the aberrant right hepatic duct, draining into the cystic duct. After reducing inflammation by perctaneous transhepatic gall bladder drainage (PTGBD), we conducted laparoscopic cholecystectomy. The gall bladder wall was stiff and the gall bladder fundus was located to the left of the ligamentum teres. We dissected the liver bed, endeavoring to avoid umbilical injury. We stapled and closed the neck of the gall bladder, without approaching the cysti duct to avoid damaging the aberrant hepatic duct. The man was discharged on post operative day 6. We found no record of such a case in the Japanese literature.

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