腹腔鏡下胆囊摘出術を施行した未破裂真性胆囊動脈瘤の1例

A case of unruptured aneurysm of cystic artery treated by laparoscopic cholecystectomy

◆要旨：患者は73歳，女性．時々自覚する心窩部痛を主訴に精査した結果，ダイナミック造影CTにて胆囊内debrisと径5mmの胆囊動脈瘤を認めた．動脈瘤破裂の既往はなかったが，将来の破裂の可能性も考慮して，腹腔鏡下胆囊摘出術を施行した．病理では真性動脈瘤と診断された．胆囊動脈瘤の本邦における報告は非常に稀であり，ほとんどが動脈瘤破裂に伴う出血例として報告されている．今回筆者らは，未破裂胆囊動脈瘤に対して安全に腹腔鏡下胆囊摘出術を施行することができた．

A 73-year-old woman consulted our hospital for epigastralgia. Dynamic CT examination revealed a debris in the gallbladder and 5mm aneurysm of cystic artery. She had no history of rupture of the aneurysm. Because of the risk of future rupture of aneurysm, laparoscopic cholecystectomy was performed. Laparoscopic clipping of cystic arterial aneurysm and subsequent cholecystectomy were performed. The histological examination revealed true-aneurysm. There are few reports of cystic artery aneurysm in Japan and almost all were reported as ruptured cases associated with cholecystitis. In conclusion, we performed laparoscopic cholecystectomy safely for unruptured aneurysm of the cystic artery.