Should We Excise the Ectopic Liver Tissue Associated with the Gallbladder Encountered during Laparoscopic Cholecystectomy? Case Report

BACKGROUND

Choristoma means the presence of normal cells or tissues in abnormal localizations. The clinic of these tissues is usually insignificant, but depending on their appearance, they can be confused with malignant masses.¹ Ectopic liver, diaphragm, hepatic ligaments, omentum, stomach, adrenal glands, pancreas, spleen, esophagus, and umbilical cord can be found in intra, extra, and retroperitoneal regions such as retroperitoneum and thorax, but the gallbladder is the most common site.² In this paper, we will present a case of hepatic choristoma, which was discovered incidentally during elective laparoscopic cholecystectomy and did not require resection.

CASE DESCRIPTION

A 44-year-old female patient was admitted to our clinic 2 months after her acute cholecystitis attack and treatment. The patient’s physical examination was normal, and laboratory analyses were normal. There was no finding in favor of choristoma in the patient with cholelithiasis in his radiological imaging. Intraoperatively, incidentally, there was an ectopic liver tissue of approximately 15 × 5 mm in size, originating from the liver on the left side of the gallbladder and attached to the serosa of the gallbladder (Fig. 1). Standard laparoscopic cholecystectomy was completed without disconnecting the hepatic choristoma from the liver. Postoperative follow-up of the patient was uneventful. The histopathological findings were chronic cholecystitis and cholelithiasis.

DISCUSSION

Hepatic choristomas are a rare condition that is usually encountered incidentally during abdominal surgery. Most hepatic choristomas are asymptomatic; rarely, they can be symptomatic.³ Ectopic tissue is usually attached to the serosa of the gallbladder or within its wall. If the ectopic liver receives its blood supply from the liver parenchyma, resection may prolong bleeding and operative time, as it may cause uncontrollable bleeding during resection. Previous studies have reported increased malignancy due to vascular nutrition and biliary drainage of the choristoma.^4,5 In recent studies, it has been determined that these choristomas do not have any findings in favor of increased malignancy.⁶ Since the risk of malignancy is not high, we did not resect the choristoma in order not to prolong the operation time and not cause complications.

ORCID

Zeki Öğüt https://orcid.org/0000-0002-7698-9586

Adem Tunçer https://orcid.org/0000-0001-5381-513X

Felat Çiftçi https://orcid.org/0000-0002-8958-7121

REFERENCES

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