Laparoscopic Roux-en-Y gastric bypass in a patient with situs inversus totalis: Case report, technical tips and review of the literature

Atwez, Abdelaziz; Keilani, Zeid

doi:10.1016/j.ijscr.2018.03.004

Cited by 20 publications

(18 citation statements)

References 22 publications

(65 reference statements)

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“…In laparoscopic procedures, careful consideration of trocar positioning is necessary [ 7 ]. However, for right-handed surgeons, this can cause some difficulties: it can be uncomfortable to handle the instruments with their left hand or the pedals with their left foot [ 8 ]. Therefore, the most important factor is the careful exploration of anatomical variations—especially the vascular anomalies that often occur—by using preoperative imaging techniques.…”

Section: Discussionmentioning

confidence: 99%

Double rarity: malignant masquerade biliary stricture in a situs inversus totalis patient

et al. 2021

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Background Situs inversus totalis is a rare anatomical variation of both the thoracic and the abdominal organs. Common bile duct strictures can be caused by malignant and benign diseases as well. 7–18% of the latter ones are 'malignant masquerade’ cases, as pre-operative differentiation is difficult. Case presentation We present the case of a 68y male patient with known situs inversus totalis and a recent onset of obstructive jaundice caused by a malignant behaving common bile duct stricture. Technically difficult endoscopic retrograde cholangiopancreatography, brush cytology, magnetic resonance cholangiopancreatography, endoscopic ultrasound, and percutaneous transhepatic drainage with stent implantation were performed for proper diagnosis. Cholecystectomy, common bile duct resection with hilar lymphadenectomy, and hepatico-jejunostomy have been performed following multidisciplinary consultation. The final histology report did not confirm any clear malignancy, the patient is doing well. Conclusion In situs inversus patients, both diagnostic and therapeutic procedures can lead to various difficulties. Benign biliary strictures are frequently misdiagnosed preoperatively as cholangiocellular carcinoma. Surgery is usually unavoidable, involving a significant risk of complications. The co-existence of these two difficult diagnostic and therapeutic features made our case challenging.

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Section: Discussionmentioning

confidence: 99%

Double rarity: malignant masquerade biliary stricture in a situs inversus totalis patient

et al. 2021

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“…In laparoscopic procedures, the careful consideration of the trocar positioning is necessary [7]. However, for right-handed surgeons, it can cause some difficulties: handling the instruments with their left hand or the pedals with their left foot can be uncomfortable [8]. Therefore, the most important factor is the careful exploration of the anatomical variations -especially the vascular anomalies that often occur -by using preoperative imaging techniques.…”

Section: Discussionmentioning

confidence: 99%

WITHDRAWN: Double Rarity: Malignant Masquerade Biliary Stricture in a Situs Inversus Totalis Patient. A Case Report

Eitler

Máthé

Papp

et al. 2020

Preprint

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Background. Situs inversus totalis is a rare anatomical variation of both the thoracic and the abdominal organs. Common bile duct strictures can be caused by malignant and benign diseases as well. 7-18% of the latter ones are 'malignant masquerade’ cases, as pre-operative differentiation is difficult. Case presentation. We present the case of a 68y male patient with known situs inversus totalis and a recent onset of obstructive jaundice caused by a malignant behaving common bile duct stricture. Technically difficult endoscopic retrograde cholangiopancreatography, brush cytology, magnetic resonance cholangiopancreatography, endoscopic ultrasound, and percutaneous transhepatic drainage with stent implantation were performed for proper diagnosis. Cholecystectomy, common bile duct resection with hilar lymphadenectomy and a hepatico-jejunostomy has been performed following multidisciplinary consultation. The final histology report did not confirm any clear malignancy, the patient is doing well.Conclusion. In situs inversus patients, both diagnostic and therapeutic procedures can lead to various difficulties. Benign biliary strictures are frequently misdiagnosed preoperatively as cholangiocellular carcinoma. The surgery is usually unavoidable, involving a significant risk of complications.The co-existence of these two difficult diagnostic and therapeutic features made our case challenging.

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“…A total of 25 articles with 27 cases were identified. These comprise 6 cases that underwent LGB,5 9–13 9 LRYGB5 14–21 and 12 LSG 22–32. Among these cases, only one case of Kartagener syndrome was identified for each LGB,11 LRYGB16 and LSG 26.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic sleeve gastrectomy in a patient withsitus inversus totalisand Kartagener syndrome: an unusual surgical conundrum

Burvill¹,

Blackham

Hamdorf

2019

BMJ Case Rep

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Kartagener syndrome is a rare autosomal recessive condition. Approximately 25% of those with situs inversus totalis suffer the syndrome. With the rising overall number and indications for bariatric surgery, this condition will be increasingly recognised. We present a case of a 25-year-old woman with SIT and Kartagener syndrome who underwent a laparoscopic sleeve gastrectomy. As with all bariatric surgery, a multidisciplinary team approach was important in managing such a case. There were considerable cognitive challenges for the surgical team both preoperatively and during the procedure. The patient tolerated the operation well and was discharged 2 days after the surgery. At 12-months follow-up, the patient had achieved 125% excess weight loss. This case illustrates that an experienced surgeon can safely perform a laparoscopic sleeve gastrectomy on a patient with situs inversus totalis.

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Laparoscopic Roux-en-Y gastric bypass in a patient with situs inversus totalis: Case report, technical tips and review of the literature

Cited by 20 publications

References 22 publications

Double rarity: malignant masquerade biliary stricture in a situs inversus totalis patient

Double rarity: malignant masquerade biliary stricture in a situs inversus totalis patient

WITHDRAWN: Double Rarity: Malignant Masquerade Biliary Stricture in a Situs Inversus Totalis Patient. A Case Report

Laparoscopic sleeve gastrectomy in a patient withsitus inversus totalisand Kartagener syndrome: an unusual surgical conundrum

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