Colecistitis aguda en un situs inversus total. Reporte de caso

Garnica-Rosales, Alberto U; Martínez-Valdés, José A; Villalpando-Velázquez, José A; Lagunas-Quiroz, Eduardo

doi:10.24875/ciru.20000906

Cited by 3 publications

(4 citation statements)

References 22 publications

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“…Despite it has been reported that SIT is not a contraindication to laparoscopic cholecystectomy 1,11,13 , it certainly poses an additional difficulty to both diagnosis and treatment of many conditions, including acute cholecystitis, due to the mirroring of all the abdominal structures 7 . Thus, SIT possibly contributed to the BDI presented in this case.…”

Section: Discussionmentioning

confidence: 99%

“…It poses additional technical difficulties during abdominal operations and in port placement during laparoscopy due to the mirror image of normal anatomy 7 . Although laparoscopic cholecystectomy has been pointed out as safe in SIT 1 , 11 , 22 some additional precautions should be considered during dissection due to the altered anatomy 7 . Multiple major surgical procedures have also been reported in patients with SIT, such as pancreatoduodenectomies 12 , 14 , 18 , common bile duct exploration 15 , resection of choledochal cysts 10 , and liver transplantation 25 , but to the best of our knowledge this is the first case of bile duct injury repair in SIT reported in the literature.…”

Section: Introductionmentioning

confidence: 99%

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Bile Duct Injury Repair in a Patient With Situs Inversus Totalis

MEIRA-JÚNIOR,

RAMOS-ARANDA,

CARRILLO-VIDALES

et al. 2024

ABCD, arq. bras. cir. dig.

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BACKGROUND: Bile duct injury (BDI) causes significant sequelae for the patient in terms of morbidity, mortality, and long-term quality of life, and should be managed in centers with expertise. Anatomical variants may contribute to a higher risk of BDI during cholecystectomy. AIMS: To report a case of bile duct injury in a patient with situs inversus totalis. METHODS: A 42-year-old female patient with a previous history of situs inversus totalis and a BDI was initially operated on simultaneously to the lesion ten years ago by a non-specialized surgeon. She was referred to a specialized center due to recurrent episodes of cholangitis and a cholestatic laboratory pattern. Cholangioresonance revealed a severe anastomotic stricture. Due to her young age and recurrent cholangitis, she was submitted to a redo hepaticojejunostomy with the Hepp-Couinaud technique. To the best of our knowledge, this is the first report of BDI repair in a patient with situs inversus totalis. RESULTS: The previous hepaticojejunostomy was undone and remade with the Hepp-Couinaud technique high in the hilar plate with a wide opening in the hepatic confluence of the bile ducts towards the left hepatic duct. The previous Roux limb was maintained. Postoperative recovery was uneventful, the drain was removed on the seventh post-operative day, and the patient is now asymptomatic, with normal bilirubin and canalicular enzymes, and no further episodes of cholestasis or cholangitis. CONCLUSIONS: Anatomical variants may increase the difficulty of both cholecystectomy and BDI repair. BDI repair should be performed in a specialized center by formal hepato-pancreato-biliary surgeons to assure a safe perioperative management and a good long-term outcome.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Bile Duct Injury Repair in a Patient With Situs Inversus Totalis

MEIRA-JÚNIOR,

RAMOS-ARANDA,

CARRILLO-VIDALES

et al. 2024

ABCD, arq. bras. cir. dig.

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“…Los cirujanos y gastroenterólogos rara vez ven pacientes con SI debido a su rareza; esta anomalía podría presentarse incluso al cirujano más experimentado en 1 o 2 veces en toda su carrera (11) . La presencia de SIT no contraindica la realización de la CL, aunque es dificultosa, esta se considera el tratamiento de primera elección en colelitiasis, siendo un método seguro, pero que demanda una reorientación de la habilidad motora y visual (1,3) , esto debido a los problemas asociados al SIT como la imagen "en espejo", las variaciones anatómicas, el posicionamiento de los puertos, y la dominancia de la mano del cirujano (1) . Si bien no existe un protocolo definido sobre la CL en pacientes con SI (3) , hay esencialmente 2 tipos de colocación de puertos de laparoscopía: la "técnica americana en espejo" y la "técnica francesa en espejo".…”

Section: Discussionunclassified

“…El término "situs" se refiere a la posición de las vísceras toracoabdominales con respecto a la línea media. El situs inversus (SI) es la posición invertida en sentido sagital de los órganos toracoabdominales, es una malformación congénita poco frecuente con herencia autosómica recesiva (1) . El SI puede ser total o parcial.…”

Section: Introductionunclassified

Colecistectomía con exploración de vías biliares laparoscópica en paciente con situs inversus totalis

Mendoza Rojas,

Martínez Cevallos,

Hinojo Chanco

2023

Rev Gastroenterol Peru

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Se presenta el caso de un paciente varón de 77 años con diagnóstico de colecistitis crónica calculosa y coledocolitiasis, con antecedente de situs inversus totalis. Se le realizó una colecistectomía con exploración de vías biliares laparoscópica, utilizando la “técnica francesa en espejo”, con extracción de los cálculos. El paciente evolucionó favorablemente. El objetivo del presente trabajo es dar a conocer el caso clínico que es poco frecuente su reporte en la literatura mundial (solo 9 casos). Su importancia radica en que sería el primer reporte de caso clínico publicado de una colecistectomía y exploración de vías biliares laparoscópica con retiro del cálculo en colédoco en un paciente con situs inversus totalis, realizado en el Perú.

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Clinical significance of Left-Sided Gallbladder for laparoscopic cholecystectomy and hepatectomy

et al. 2023

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A left-sided gallbladder (LSG) represents a rare anatomical variation defined by the location of the gallbladder to the left side of the liver falciform and round ligaments, which is often not discovered until surgery. The reported prevalence of this ectopia ranges from 0.2% to 1.1%, however, those values may be underestimated. It is mostly an asymptomatic condition, thus not causing the patient any harm, and being few reported cases in the current literature. Based on clinical presentation and standard diagnostic procedures, LSG can remain undetected and represent accidental intraoperative finding. The attempts to explain the cause of this anomaly have been different, but the numerous variations described do not allow a clear definition of its origin. Although this debate is still open, it is of considerable importance to know that LSG is frequently associated with alterations of both the portal branches and the intrahepatic biliary tree. The association of these anomalies, therefore, represents an important risk of complications in cases when surgical treatment is necessary. In this context, our literature review aimed to summarize possible anatomical anomalies coexisting with LSG and discuss the clinical significance of the LSG, when the patient requires cholecystectomy or hepatectomy.

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Colecistitis aguda en un situs inversus total. Reporte de caso

Cited by 3 publications

References 22 publications

Bile Duct Injury Repair in a Patient With Situs Inversus Totalis

Bile Duct Injury Repair in a Patient With Situs Inversus Totalis

Colecistectomía con exploración de vías biliares laparoscópica en paciente con situs inversus totalis

Clinical significance of Left-Sided Gallbladder for laparoscopic cholecystectomy and hepatectomy

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