Dystopic retrohepatic gallbladder and cholecysto‐choledocho lithiasis: the rendez‐vous and indocyanine green fluorescence

Mattone, Edoardo; Latteri, Saverio; Teodoro, Michele; Pesce, Antonio; Mannino, Maurizio; Romano, Giulia; Russello, Domenico; Greca, Gaetano La

doi:10.1002/ccr3.1130

Cited by 6 publications

(6 citation statements)

References 10 publications

(10 reference statements)

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“…The other abnormal positions for the gall bladder are supra-hepatic (located in the falciform ligament) and the floating gall bladder (located in the anterior abdominal wall). 1 , 7 A new classification describes three abnormal positions of gall bladder: (1) left-sided gall bladder associated with situs inversus, (2) true left-sided gall bladder; most common variety, and (3) right left-sided gall bladder. 3 , 8 …”

Section: Discussionmentioning

confidence: 99%

“…The other abnormal positions for the gall bladder are suprahepatic (located in the falciform ligament) and the floating gall bladder (located in the anterior abdominal wall). 1,7 A new classification describes three abnormal positions of gall bladder: (1) left-sided gall bladder associated with situs inversus, (2) true left-sided gall bladder; most common variety, and (3) right left-sided gall bladder. 3,8 The incidence rate of 83% has been reported for the true left-sided gall bladder and 16% due to abnormally placed falciform ligament, in a study done on patients with leftsided gall bladder without situs inversus.…”

Section: Discussionmentioning

confidence: 99%

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Ectopic gall bladder: A case report

Yadav

Ray

Nundy

2021

SAGE Open Medical Case Reports

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Ectopic gall bladder under the left lobe of liver is a rare congenital anomaly of the position of gall bladder, which is mostly detected during surgery and causes technical difficulty at the time of operation. We operated a 64-year-old male who presented with gall stone disease and pre-operative ultrasound did not report any abnormality in position. On laparoscopy, it was found to be attached on the left side of falciform ligament under segment III. It was a true ectopic gall bladder without situs inversus. Early division of the falciform ligament and a careful and complete dissection of the gall bladder are advocated before clipping the cystic artery and duct to avoid complications. The present case report discusses about this rare anomaly and the available literature on the subject.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Ectopic gall bladder: A case report

Yadav

Ray

Nundy

2021

SAGE Open Medical Case Reports

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“…In the present case acalculous cholecystitis was related with mechanical ventilation and prolonged total parenteral nutrition, instead the gangrenous histopathology pattern was probably caused by severe acute respiratory distress syndrome of COVID-19 pneumonia which determined vascular insufficiency, responsible of gallbladder wall ischemia. Although laparoscopic cholecystectomy is considered the gold standard for the treatment of most gallbladder disease [ 12 ], Tokyo Guidelines advice to delay surgical operation and to perform the percutaneous gallbladder drainage for surgically high-risk patients with acute cholecystitis and comorbidities [ 13 ]. Multidisciplinary team decided to perform surgery after cholecystostomy due to worsening clinical condition of the patient, presenting fever and right upper quadrant abdominal pain and patient agreed with doctors because of his poor clinical conditions.…”

Section: Discussionmentioning

confidence: 99%

Acute acalculous cholecystitis on a COVID-19 patient: a case report

Mattone

Miceli

Schembari

et al. 2020

Annals of Medicine and Surgery

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Introduction We report an extremely rare case of acute acalculous cholecystitis on a COVID-19 patient. In our knowledge, this is the first report of laparoscopic cholecystectomy performed on a COVID-19 patient. Presentation of case A COVID-19 patient was diagnosed with acute acalculous cholecystitis and a multidisciplinary team decided to perform a percutaneous transhepatic biliary drainage (PTBD) as the first treatment. SARS-CoV-2 RNA was not found in the bile fluid. Because of deterioration of the patient's clinical conditions, laparoscopic cholecystectomy had to be performed and since the gallbladder was gangrenous, the severe inflammation made surgery difficult to perform. Discussion Acalculous cholecystitis was related with mechanical ventilation and prolonged total parenteral nutrition, in this case the gangrenous histopathology pattern and the gallbladder wall ischemia was probably caused by vascular insufficiency secondary to severe acute respiratory distress syndrome of COVID-19 pneumonia. The percutaneous transhepatic gallbladder drainage (PTBD) was performed according to Tokyo Guidelines because of high surgical risk. Laparoscopic cholecystectomy was next performed due to no clinical improvement. The absence of viral RNA in the bile highlights that SARS-CoV-2 is not eliminated with the bile while it probably infects small intestinal enterocytes which is responsible of gastrointestinal symptoms such as anorexia, nausea, vomiting, and diarrhoea. Conclusions Although the lack of evidence and guidelines about the management of patient with acute cholecystitis during COVID-19 pandemic, laparoscopic cholecystectomy, at most preceded by PTGBD on high surgical risk patients, remains the gold standard for the treatment of acute cholecystitis on COVID-19 patients.

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“…In the present case acalculous cholecystitis was related with mechanical ventilation and prolonged total parenteral nutrition, instead the gangrenous histopathology pattern was probably caused by severe acute respiratory distress syndrome of COVID-19 pneumonia which determined vascular insu ciency, responsible of gallbladder wall ischemia. Although laparoscopic cholecystectomy is considered the gold standard for the the treatment of most gallbladder disease 11 , Tokyo Guidelines advice to delay surgical operation and to perform the percutaneous gallbladder drainage for surgically high-risk patients with acute cholecystitis and comorbidities 12 . Multidisciplinary team decide to perform surgery after cholecystostomy due to worsening clinical condition of the patient, presenting fever and right upper quadrant abdominal pain.…”

Section: Discussionmentioning

confidence: 99%

Acute acalculous cholecystitis on a COVID-19 patient: a case report

Mattone

Sofia

Schembari

et al. 2020

Preprint

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Background coronavirus disease-19 (COVID-19) has spread to several countries around the world and has become an unprecedented pandemic. We report an extremely rare case of acute acalculous cholecystitis on a COVID-19 patient. In our knowledge, this is the first report of laparoscopic cholecystectomy performed on a COVID-19 patient. Case presentation: a COVID-19 patient was diagnosed with acute acalculous cholecystitis and a multidisciplinary team decided to perform a percutaneous transhepatic biliary drainage (PTBD) as the first treatment. SARS-CoV-2 RNA was not found in the bile fluid. Because of deterioration of the patient’s clinical conditions, laparoscopic cholecystectomy had to be performed and since the gallbladder was gangrenous, the severe inflammation made surgery difficult to perform. Conclusions acalculous cholecystitis was related with mechanical ventilation and prolonged total parenteral nutrition, in this case the gangrenous histopathology pattern and the gallbladder wall ischemia was probably caused by vascular insufficiency secondary to severe acute respiratory distress syndrome of COVID-19 pneumonia. The percutaneous transhepatic gallbladder drainage (PTBD) was performed according to Tokyo Guidelines because of high surgical risk. Laparoscopic cholecystectomy was next performed due to no clinical improvement. The absence of viral RNA in the bile highlights that SARS-CoV-2 is not eliminated with the bile while it probably infects small intestinal enterocytes which is responsible of gastrointestinal symptoms such as anorexia, nausea, vomiting, and diarrhea. Although the lack of evidence and guidelines about the management of patient with acute cholecystitis during COVID-19 pandemic, laparoscopic cholecystectomy, at most preceded by PTGBD on high surgical risk patients, remains the gold standard for the treatment of acute cholecystitis on COVID-19 patients.

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Dystopic retrohepatic gallbladder and cholecysto‐choledocho lithiasis: the rendez‐vous and indocyanine green fluorescence

Cited by 6 publications

References 10 publications

Ectopic gall bladder: A case report

Ectopic gall bladder: A case report

Acute acalculous cholecystitis on a COVID-19 patient: a case report

Acute acalculous cholecystitis on a COVID-19 patient: a case report

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