Left gallbladder: surgical challenge in laparoscopic cholecystectomy: a case report

Jorge D. S. M. Vizcaino; Mauricio G.  Blas; Jennifer H. Licona

doi:10.18203/2320-6012.ijrms20252041

Authors

Jorge D. S. M. Vizcaino Department of General Surgery, General Hospital No. 7, Cuautla, Morelos, Mexico
Mauricio G. Blas Department of General Surgery, General Hospital No. 7, Cuautla, Morelos, Mexico
Jennifer H. Licona Department of General Surgery, National Medical Center SXXI, Mexico City, CDMX, México

DOI:

https://doi.org/10.18203/2320-6012.ijrms20252041

Keywords:

Left-sided gallbladder, Laparoscopic cholecistectomy, Sinistraposition

Abstract

Left-sided gallbladder (LSGB) without situs inversus is a rare genetic anatomical abnormality, defined by the location of the gallbladder to the left side of the liver falciform and round ligaments, with incidences ranging from 0.04% to 0-7% according to various literature reports. It is gaining relevance as it becomes a surgical challenge given the potential variants of the biliary tract. This article describes the case of 55-year-old female scheduled for elective laparoscopic cholecystectomy due to 3-months-old cholelithiasis, incidentally diagnosed, in which a left gallbladder was identified. She underwent multiport laparoscopic cholecystectomy (LC), where a gallbladder implanted on the left side (in the hepatic segment III) was identified with no other apparent anomalies of the biliary tree. The procedure was performed without incident. LSGB without situs inversus, also known as “sinistraposition,” is a rare and often incidental finding that can represents a technical and surgical challenge for the general surgeon unrelated to these variants, thus increasing morbidity.

Metrics

Metrics Loading ...

References

Chousleb E, Chousleb A, Shuchleib C. Actual status of laparoscopic cholecystectomy. Revista de Gastroenterologia de Mexico. 2004;69(1):28-35.

Si-Youn R, Poong-Man J. Left-sided gallbladder with right-sided ligamentum teres hepatis: rare associated anomaly of exomphalos. J Pediatr Surg. 2008;1390-5. DOI: https://doi.org/10.1016/j.jpedsurg.2008.03.033

Hochstetter F. Anomaliem der pfortader und der nabelvene in verbindung mit defect order Linskcage der gall en blase. Arch Anat Entwick. 1886;369-95.

Gross R. Congenital anomalies of the gallbladder. Arch Surg. 1936;32:131-62. DOI: https://doi.org/10.1001/archsurg.1936.01180190134008

Ikoma A, Tamaka K, Hamada N. Left sided gallbladder with accessory liver accompanied by intra-hepatic cholangiocarcina. J Jpn Surgery Soc. 1992;93:434-6.

Rozsos I, Ferenczy J, Vincze K, Rainer S. Left-sided gall-bladder. Magy Seb. 2002;55:329-30.

Reddy PK, Subramanian RV, Yuvaraja S. Laparoscopic cholecystectomy for left-sided gallbladder (sinistroposition). JSLS: J Soc Laparoendosc Surg/Soc Laparoendosc Surg. 2005;9(3):356-67.

Makni A, Magherbi H, Rachid K, Wael R, Zoubeir BS. Left-sided gallbladder: An incidental finding on laparoscopic cholecystectomy. Asian J Surg. 2012;35:93-5. DOI: https://doi.org/10.1016/j.asjsur.2012.04.011

Schiffino L, Mouro J, Levard H, Dubois F. A case of a left-sided gallbladder treated surgically via laparoscopy. Ann Ital Chir. 1993;64:229-31.

Maetani Y, Itoh K, Kojima N, Tabuchi T, Shibata T, Asonuma K, et al. Portal vein anomaly associated with deviation of the ligamentum teres to the right and malposition of the gallbladder. Radiology. 1998;207(3):723. DOI: https://doi.org/10.1148/radiology.207.3.9609896

Nastos C, Vezakis A, Papaconstantinou I, Theodosopoulos T, Koutoulidis V, Polumeneas G. Methods of safe laparoscopic cholecystectomy for left-sided (sinistroposition) gallbladder: A report of two cases and a review of safe techniques. Int J Surg Case Rep. 2014;769-74. DOI: https://doi.org/10.1016/j.ijscr.2014.08.018

Zheng B, Li C, Wang S, Wu J. Laparoscopic cholecystectomy for true left-sided gallbladder: A rare anatomical anomaly and the related diagnosis and treatment challenges. Asian J Surg. 2022;45(12):3012-3. DOI: https://doi.org/10.1016/j.asjsur.2022.06.147

Szymoniuk M, Brachet A, Ciejka K, Zielkowska A, Błaszczyk J, Burdan O, et al. Clinical significance of Left-Sided Gallbladder for laparoscopic cholecystectomy and hepatectomy. Pol Przegl Chir. 2023;95(4):1-5. DOI: https://doi.org/10.5604/01.3001.0016.2124

Iskandar ME, Radzio A, Krikhely M, Leitman IM. Laparoscopic cholecystectomy for a left-sided gallbladder. World J Gastroenterol. 2013;19(35):5925-8. DOI: https://doi.org/10.3748/wjg.v19.i35.5925

Malla S, Karki S, Bohara S, Upadhaya Regmi B, Bhat PS, Sedhai S, et al. Sinistroposition: A case report on incidental finding of left sided gall bladder on laparoscopic cholecystectomy. Ann Med Surg (Lond). 2022;81:104547. DOI: https://doi.org/10.1016/j.amsu.2022.104547