Laparoscopic cholecystectomy for patients with accessory liver lobe attached to the wall of the gallbladder: case reports

TL;DR

This paper reports two cases where a rare liver anomaly was found during gallbladder surgery and discusses the importance of complete removal to avoid complications.

Contribution

The paper presents two new clinical cases of accessory liver lobes attached to the gallbladder during laparoscopic cholecystectomy.

Findings

Accessory liver lobes were successfully resected during laparoscopic cholecystectomy in two patients.

Pathological analysis confirmed the presence of normal liver tissue in the accessory lobes.

Incomplete resection of accessory liver lobes may lead to postoperative complications like bleeding or bile leakage.

Abstract

Laparoscopic cholecystectomy (LC) is one of the most commonly undertaken procedures worldwide for cholecystolithiasis and cholecystitis. Accessory liver lobe (ALL) is a developmental anomaly defined as an excessive liver lobe composed of a normal liver parenchyma. Some ALL exist on the serosal side of the gallbladder. We herein present two cases of ALL incidentally detected during LC.

The first case was a 69-year-old woman diagnosed with chronic cholecystitis. LC was performed. ALL was observed anterior to the wall of the gallbladder and resected after clipping. Pathological findings revealed liver tissue with Glisson’s capsule and a lobular structure in ALL. However, communication between the bile ducts of ALL and the main liver was unclear due to surgical heat degeneration. The second case was a 56-year-old woman diagnosed with acute cholecystitis. LC was performed approximately one month after the attack, and ALL attached to the wall of gallbladder. ALL was clipped and completely resected. Pathological findings showed that the bile ducts of ALL might be connected within the wall of gallbladder.

We presented two cases of ALL attached to the gallbladder encountered during LC. Since ALL contains a normal liver parenchyma, postoperative bleeding or bile leakage may occur if it is inefficiently resected. Therefore, the complete resection of ALL is important to prevent these postoperative complications.

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