Surgical implications of a left-sided gallbladder

Left Side Located Cholelithiasis Case

“…If the cystic duct from a left-sided gallbladder joins the common hepatic duct from its right side, the variation has been regarded as a defect migration; if the cystic duct merges with the common hepatic duct on its left side or drains into the left hepatic duct, left-sided budding of the gallbladder/cystic duct anlage in the embryo has been proposed [5,6]. Moreover, some authors have regarded the left-sided gallbladder as the result of a poorly developed quadrate lobe while others have seen the right-sided round ligament as the true cause of the problem [3,5]. Associated anomalies with left-sided gallbladder include complete or partial situs inversus, duplicated gallbladder, hypoplastic bile duct, anomalous pancreato-biliary ductal junction, absence of the quadrate lobe, accessory liver, and anomalous intrahepatic branching of the portal vein [7].…”

“…Associated anomalies with left-sided gallbladder include complete or partial situs inversus, duplicated gallbladder, hypoplastic bile duct, anomalous pancreato-biliary ductal junction, absence of the quadrate lobe, accessory liver, and anomalous intrahepatic branching of the portal vein [7]. It has also been associated with complex congenital abnormalities such as the main bile duct lying in front of the first part of the duodenum and malrotation of the intestine, an anteduodenal portal vein, an anular pancreas, agenesis of the dorsal pancreas, polysplenia and highly mobile right colon, liver cyst, and with intrapelvic ectopic testis with ectopic vesica and an umbilical hernia [3,7]. Recent data indicate that routine ultrasonography in patients with gallstone disease may fail to identify left-sided gallbladder disease.…”

“…Recent data indicate that routine ultrasonography in patients with gallstone disease may fail to identify left-sided gallbladder disease. A left-sided gallbladder increases the risk of bile duct injury during laparoscopic cholecystectomy [3]. As associated anomalies are to be expected with left-sided gallbladder, the surgeon has to be cautious while performing laparoscopic cholecystectomy.…”

“…The position of the gallbladder in relation to the liver may vary, with documented cases such as transverse, intrahepatic, retrodisplaced, and left-sided [2]. Such variants are very rare: reported cases of a left-sided gallbladder have been no more than 200; the incidence is 0.4% [3]. Left-sided gallbladder is often accompanied by biliary, portal venous, and other anomalies that might lead to intra-operative injuries.…”

Ectopic liver and gallbladder in a cloned dog: Possible nonheritable anomaly

“…Important congenital abnormalities of a gallbladder are related to number (agenesis, bilobed or multiseptate gallbladder), shape (Phrygian cap, diverticulum, or hypoplasia), or position (ectopic gallbladder) [5,44]. The four most common ectopic locations are under the left liver lobe, inside the liver, transverse, and retroplaced [18,19,[45][46][47]. However, there is an exceptional case which did not belong to this classification.…”