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Clinical practice -- difficulties in the diagnostics 2012



V. Tasev, D. Bulanov, A. Taseva and V. Solunkin
Department of General and Liver-Рancreatic Surgery, University Hospital “Alexandrovska” – Sofia
Medical University – Sofia

Summary: Double gallbladder is a rare anatomical malformation. It can be identified by preoperative imaging methods, but on the other hand that doesn’t always happen. Experience shows that in such cases is expected to have other developmental abnormalities of the hepatobiliary system, especially with regard to the extrahepatic bile ducts and location of the hepatic artery and the cystic artery. Therefore, such a finding might put the operational team to the test. Described iatrogenic lesions in minimal invasive cholecystectomy do not diminish over time, which gave us reason to introduce such a clinical case. The purpose of this communication is to clarify the possible variants of this anomaly and put to the discussion – “how far with the laparoscopic technique?” We present the case of a young woman suffering from biliary crises for several years. Echographically caliculi can be established in the gallbladder. The double gallbladder can be identified intraoperatively. The operation is completed successfully laparoscopically. In conclusion, we believe that every surgical team must find adequate balance between clinical experience with laparoscopic operations, technical equipment and opportunities on the one hand and the desire for successful completion of the surgery on the other, even if that requires conversion, in the interest of the patient’s health.
Key words: laparoscopic cholecystectomy, anomaly, gallbladder
Address for correspondence: Assoc. Prof. Vladimir Tasev, MD, PhD, Clinic of General, Hepatobilliary and Pancreatic Surgery, University Hospital “Alexandrovska”, 1 “Sv. G. Sofiuski” str., Bg – 1431 Sofia, tel.: +359 2 9230262, e-mail:

V. Tasev, D. Boulanov, A. Taseva, K. Dimitrov, I. Taneva, P. Tokov, A. Yonkov and V. Dimitrova
Department of General and Liver-Pancreatic Surgery,
UMHAT “Alexandrovska”, Medical University – Sofia

Summary: Primary hydatid cyst of the pancreas is rare. We report four cases, which presented with various clinical signs. The imaging studies were unhelpful in identifying the etiology. Pancreatic hydatid cysts were established at the time of surgery. Diagnosis was confirmed by histological and parasitological examination.
Key words: hydatid cyst, surgery, pancreas
Address for correspondence: Assoc. Prof. Vladimir Tasev, MD, PhD, Department of General and Liver-Pancreatic Surgery, University Hospital “Alexandrovska”, 1 G. Sofiyski” str., Bg-1431 Sofia, tel.: +359 2 9230262, e-mail: vntasev@abv. bg

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