A left-sided gallbladder without a right-sided round ligament, which is called a true left-sided gallbladder, is extremely rare. A 71-year-old woman was referred to our hospital due to a gallbladder polyp. Computed tomography (CT) revealed not only a gallbladder polyp but also the gallbladder located to the left of the round ligament connected to the left umbilical portion. CT portography revealed that the main portal vein diverged into the right posterior portal vein and the common trunk of the left portal vein and right anterior portal vein. CT cholangiography revealed that the infraportal bile duct of segment 2 joined the common bile duct. Laparoscopic cholecystectomy was performed for a gallbladder polyp, and the intraoperative finding showed that the cholecystic veins joined the round ligament. A true left-sided gallbladder is closely associated with several anomalies; therefore, surgeons encountering a true left-sided gallbladder should be aware of the potential for these anomalies.
A 46-year-old man who had been diagnosed with von Willebrand disease consulted our hospital because of diarrhea and melena. Several examinations revealed a submucosal rectal tumor and early rectal cancer. Further investigation revealed type 2A von Willebrand disease and a slightly prolonged activated partial thromboplastin time. Using activated partial thromboplastin time as an index, we administered blood clotting factor Ⅷ /von Willebrand factor concentrate, and performed local excision and endoscopic submucosal dissection of the rectal tumor. For additional bowel resection, laparoscopic low anterior resection was performed. Thus, we safely performed laparoscopic low anterior resection in a patient with von Willebrand disease by supplying factor Ⅷ /von Willebrand factor concentrate. Key words:von Willebrand disease,rectal cancer,laparoscopic surgery
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.