Ectopic Pancreatic Tissue in the Gallbladder Following Laparoscopic Cholecystectomy: A Rare Case.

Abstract

Ectopic pancreatic tissue (EPT) is a rare clinical condition characterized by the presence of pancreatic tissue without any anatomical or vascular connection to the main pancreas. We aim to present a highly unusual case of EPT (fewer than 40 reported cases in the literature), located in the wall of the gallbladder. A 41-year-old female presented with episodes of right upper quadrant and epigastric pain, nausea, and vomiting. Diagnostic imaging revealed multiple gallstones, with the largest measuring 12 mm. The gallbladder wall was normal in thickness, and there were no abnormalities in the liver, bile ducts, spleen, or pancreas. Laboratory tests were normal, except for iron-deficiency anemia. Amylase and lipase levels were within normal limits. The patient underwent an uncomplicated elective laparoscopic cholecystectomy. Pathological examination of the gallbladder revealed chronic cholecystitis and EPT classified as type 3 EPT according to the Gaspar Fuentes classification. Due to its various clinical presentations and the low discriminative power of routine imaging tests, preoperative diagnosis of EPT is nearly impossible. However, considering the potential for malignant transformation and complications of EPT, physicians should be aware of this clinical entity and consider cholecystectomy when there is a high degree of suspicion. EPT in the gallbladder is an extremely rare finding. Patients are either asymptomatic or present with nonspecific symptoms, and the definitive diagnosis is almost always made through pathological examination following cholecystectomy.