Left-sided gallbladder (Sinistroposition) encountered during laparoscopic cholecystectomy: A rare case report and review of the literature

Abstract

HighlightsLSG is a peculiar anatomical variation that is difficult to be identified preoperatively.LSG is associated with anatomical anomalies that may lead to intra-operative injuries.Safe laparoscopic cholecystectomy is feasible by placing the patient to left-side up position for better exposure of the operative field.

Left-sided gall bladder found incidentally during emergency laparoscopic appendectomy due to acute appendicitis

“…4 There are recent cases where neither the preoperative abdominal computed tomography (CT) detect the left-sided gall bladder. 5 The left-sided gall bladder is commonly discovered at surgery, since pre-operative examination may not detect the anomaly, as it happened in study case. 5 In study case, on abdominal US gall bladder was described as normal, without any anatomic variant.…”

“…5 The left-sided gall bladder is commonly discovered at surgery, since pre-operative examination may not detect the anomaly, as it happened in study case. 5 In study case, on abdominal US gall bladder was described as normal, without any anatomic variant. This was probably because the indication for an abdominal US was suspected acute appendicitis and the radiologist was paying no specific attention to the gallbladder.…”

“…6,7 Although the presence of the left-sided gallbladder with its usual anatomical anomalies might lead to intra-operative injuries, laparoscopic cholecystectomy is the treatment of choice for gall stones or acute cholecystitis. 5 The feasibility of laparoscopic cholecystectomy with minor modifications in patients with left-sided gallbladder has been confirmed in various case reports. 8 …”

True left‐sided gallbladder: a rare anatomical anomaly and its associated surgical challenges

“…Patient positioning is also important when port placements are modified. Many LCs are completed by placing the patient left‐side up instead . Reddy et al .…”

“…Obtaining the critical view of Calot's triangle is paramount in identifying critical structures and avoiding intraoperative complications such as bile duct injuries . LC in LSG have been performed through both normograde and fundus‐first retrograde dissection . We suggest proceeding with normograde dissection if possible and performing an intraoperative cholangiogram to evaluate the biliary anatomy and exclude intraoperative biliary injuries.…”