肝内胆囊伴胆囊结石的治疗体会及文献综述
Therapeutic Experience and Literature Review of Intrahepatic Gallbladder with Gallstones
DOI: 10.12677/acm.2025.15102843, PDF,    科研立项经费支持
作者: 袁韶霖, 苏秋玲：南京中医药大学第一临床医学院，江苏 南京；南京中医药大学附属医院普外科，江苏 南京；江志伟, 柳欣欣*：南京中医药大学第一临床医学院，江苏 南京；南京中医药大学附属医院普外科，江苏 南京；江苏省中医院普外科，江苏 南京
关键词: 异位胆囊；肝内胆囊；腹腔镜；胆道镜；保胆取石术；Ectopic Gallbladder； Intrahepatic Gallbladder； Laparoscopy； Choledochoscopy； Gallbladder-Preserving Cholecystolithotomy
摘要: 肝内胆囊是先天性异位胆囊中较常见的第二种，由于胆囊被肝脏完全或部分包裹，阻碍了胆囊排空，既增加了胆囊病变的风险，也给诊断和手术带来了更多挑战。目的：本文旨在探讨肝内胆囊伴胆囊结石的手术方式。方法：应用腹腔镜联合胆道镜保胆取石术治疗肝内胆囊伴胆囊结石。结果：成功实施腹腔镜联合胆道镜保胆取石术，术中、术后无并发症。结论：腹腔镜联合胆道镜保胆取石术是治疗浅表型肝内胆囊伴单发胆囊结石的安全有效的治疗方法。
Abstract: The intrahepatic gallbladder is the second most common type of congenital ectopic gallbladder. This both increases the risk of gallbladder pathology and creates additional diagnostic and surgical challenges, as the gallbladder is completely or partially encased by the liver, which prevents it from emptying. Objective: This article discusses the surgical approach to intrahepatic gallbladder with cholecystolithiasis. Methods: Therapy of intrahepatic gallbladder with cholecystolithiasis by laparoscopic combined choledochoscopic cholecystectomy for cholecystolithotripsy. Results: Successful laparoscopic gallbladder-preserving cholecystolithotomy by laparoscopic combined choledochoscopic without intraoperative and postoperative complications. Conclusion: Gallbladder-preserving cholecystolithotomy by laparoscopic combined choledochoscopic is a safe and effective treatment for superficial intrahepatic gallbladder with solitary cholecystolithiasis.
文章引用：袁韶霖, 苏秋玲, 江志伟, 柳欣欣. 肝内胆囊伴胆囊结石的治疗体会及文献综述[J]. 临床医学进展, 2025, 15(10): 962-969. https://doi.org/10.12677/acm.2025.15102843

参考文献

[1] Ploneda-Valencia, C.F., Gallo-Morales, M., Rinchon, C., Navarro-Muñiz, E., Bautista-López, C.A., de la Cerda-Trujillo, L.F., et al. (2017) Gallstone Ileus: An Overview of the Literature. Revista de Gastroenterología de México (English Edition), 82, 248-254. [Google Scholar] [CrossRef] 
[2] Chang, L., Chang, M., Chang, H.M., Chang, A.I. and Chang, F. (2018) Clinical and Radiological Diagnosis of Gallstone Ileus: A Mini Review. Emergency Radiology, 25, 189-196. [Google Scholar] [CrossRef] [PubMed]
[3] Hernandez, F. (2023) Intrahepatic Gallbladder Associated with Fitz-HughCurtis Syndrome: A Case Report. American Journal of Biomedical Science & Research, 18, 24-26.
[4] Chandrasekar, G. and Nagappa, V. (2017) Cholelithiasis in an Intrahepatic Gallbladder. International Surgery Journal, 4, 3177-3179. [Google Scholar] [CrossRef] 
[5] Falk, V., Low, G., Bigam, D. and Sandha, G. (2018) Acute Acalculous Cholecystitis of an Intrahepatic Gallbladder Causing Mirizzi’s Syndrome. BMJ Case Reports, 2018, bcr-2018-224365. [Google Scholar] [CrossRef] [PubMed]
[6] Dai, X. (2013) Gallstone Ileus: Case Report and Literature Review. World Journal of Gastroenterology, 19, 5586-5589. [Google Scholar] [CrossRef] [PubMed]
[7] Bharathy, K.G.S., Borle, D. and Kumar, N. (2017) Acute Calculous Cholecystitis with Intrahepatic Gallbladder Perforation. JAMA Surgery, 152, 403-404. [Google Scholar] [CrossRef] [PubMed]
[8] Nuño-Guzmán, C.M. (2016) Gallstone Ileus, Clinical Presentation, Diagnostic and Treatment Approach. World Journal of Gastrointestinal Surgery, 8, 65-76. [Google Scholar] [CrossRef] [PubMed]
[9] Ploneda-Valencia, C.F., Sainz-Escárrega, V.H., Gallo-Morales, M., Navarro-Muñiz, E., Bautista-López, C.A., Valenzuela-Pérez, J.A., et al. (2015) Karewsky Syndrome: A Case Report and Review of the Literature. International Journal of Surgery Case Reports, 12, 143-145. [Google Scholar] [CrossRef] [PubMed]
[10] Abou-Khalil, J.E. and Bertens, K.A. (2019) Embryology, Anatomy, and Imaging of the Biliary Tree. Surgical Clinics of North America, 99, 163-174. [Google Scholar] [CrossRef] [PubMed]
[11] Ando, H. (2010) Embryology of the Biliary Tract. Digestive Surgery, 27, 87-89. [Google Scholar] [CrossRef] [PubMed]
[12] Bridges, K., Vemulapalli, P., O’Driscoll, K., Han, J., Sexton, J. and Gilchrist, B. (2023) The First Ever Described Transhepatic Gallbladder. SVOA Medical Research, 1, 12-16. [Google Scholar] [CrossRef] 
[13] Taha, A. and Hassan, N. (2025) Post-Cholecystectomy Gallstone Ileus: A Narrative Review. Cureus, 17, e81631. [Google Scholar] [CrossRef] [PubMed]
[14] Rabeea, H., Rashid, M., Rehman, A.K., et al. (2022) Intrahepatic Gallbladder: A Case Report. Life and Science, 3, Article 3. [Google Scholar] [CrossRef] 
[15] 孙凡淇, 许英晨. 胆石性肠梗阻1例并文献复习[J]. 中国现代医生, 2023, 61(34): 125-128.
[16] Chuah, P.S., Curtis, J., Misra, N., Hikmat, D. and Chawla, S. (2017) Pictorial Review: The Pearls and Pitfalls of the Radiological Manifestations of Gallstone Ileus. Abdominal Radiology, 42, 1169-1175. [Google Scholar] [CrossRef] [PubMed]
[17] Helmy, N.A. and Ryska, O. (2023) Gallstone Ileus Post-Cholecystectomy: A Case Review. Cureus, 15, e33345. [Google Scholar] [CrossRef] [PubMed]
[18] Kalu, U., Ansari, A., Maheshwari, G. and Joshi, S. (2025) Double Large Gallstones Ileus: An Unusual Cause of Mechanical Large Bowel Obstruction. Cureus, 17, e81020. [Google Scholar] [CrossRef] [PubMed]
[19] Beuran, M. and Ivanov Iventer, M.D. (2010) Gallstone Ileus—Clinical and Therapeutic Aspects. Journal of Medicine and Life, 3, 365-371.
[20] Lee, H.G., Hwang, S., Joo, Y., Cho, Y. and Choi, K. (2015) Gallstone Ileus Inducing Obstructive Jaundice at the Afferent Loop of Roux-en-Y Hepaticojejunostomy after Bile Duct Cancer Surgery: A Case Report. Korean Journal of Hepato-Biliary-Pancreatic Surgery, 19, 78-81. [Google Scholar] [CrossRef] [PubMed]
[21] Al-Tarakji, M., AlFkey, R., Aljohary, H., Sameer, M. and Muhammad Ali, S. (2021) Successful Surgical Management of Unusual Gallbladder Anatomy through Laparoscopic Cholecystectomy of Ectopic Gallbladder. Cureus, 13, e19884. [Google Scholar] [CrossRef] [PubMed]
[22] Doudakmanis, C., Dimeas, G., Dimeas, I.E., Pitsilka, M.M. and Daniil, Z. (2023) Intrahepatic Gallbladder Rupture and Biloma Mimicking Pulmonary Embolism Following Orthopedic Surgery. Cureus, 15, e46905. [Google Scholar] [CrossRef] [PubMed]
[23] Goyal, A. and Srivastava, A. (2008) Gallstone Ileus Following Endoscopic Retrograde Cholangiopancreatography and Sphincterotomy: A Case Report. Journal of Medical Case Reports, 2, Article No. 342. [Google Scholar] [CrossRef] [PubMed]
[24] Monib, S., Mahapatra, P. and Fayez, H. (2019) Intrahepatic Gallbladder. European Journal of Case Reports in Internal Medicine, 6, 1-3. [Google Scholar] [CrossRef] [PubMed]
[25] Nakamoto, Y., Saga, T., Fujishiro, S., Washida, M., Churiki, M. and Matsuda, K. (1998) Gallstone Ileus with Impaction at the Neck of a Meckel’s Diverticulum. The British Journal of Radiology, 71, 1320-1322. [Google Scholar] [CrossRef] [PubMed]
[26] Aliniagerdroudbari, E., Ershadinia, N., Bagherpor, G. and Babaniamansour, S. (2020) A Rare Case of Simultaneous Intrahepatic and Porcelain Gallbladder: Case Report. International Medical Case Reports Journal, 15, 271-274.
[27] Chilana, A.S., Singh, P.K. and Bhattacharya, K. (2023) Intrahepatic Gallbladder Mimicking as “Hernia of the Gallbladder”. Indian Journal of Surgery, 85, 1308-1308. [Google Scholar] [CrossRef] 
[28] Mathis, R., Stodghill, J., Shaver, T. and Younan, G. (2017) Cholecystectomy of an Intrahepatic Gallbladder in an Ectopic Pelvic Liver: A Case Report and Review of the Literature. Case Reports in Surgery, 2017, 1-5. [Google Scholar] [CrossRef] [PubMed]
[29] Ramos, G.P. and Chiang, N. (2018) Bouveret’s Syndrome. New England Journal of Medicine, 378, 1335. [Google Scholar] [CrossRef] [PubMed]
[30] Dong, Z.W., Min, Q.Q., Zeng, Q.T., et al. (2021) Laparoscopic and Choledochoscopic Gallbladder-Preserving Cholecystolithotomy for an Intrahepatic Gallbladder with Cholecystolithiasis: A Case Report. Asian Journal of Surgery, 44, 1182-1183. [Google Scholar] [CrossRef] [PubMed]

为你推荐