REVIEW OF LITERATURE 

Laparoscopic cholecystectomy for a left-sided gallbladder

Mazen E Iskandar, Agnes Radzio, Merab Krikhely, I Michael Leitman

Mazen E Iskandar, Agnes Radzio, Merab Krikhely, I Michael Leitman, Department of Surgery, Albert Einstein College of Medicine-Beth Israel Medical Center, New York, NY 10003, United States

Author contributions: Iskandar ME, Radzio A, Krikhely M and Leitman IM contributed to the designing, drafting, editing and approval of the final version of this manuscript; Krikhely M performed the operation.

Correspondence to: I Michael Leitman, MD, Department of Surgery, Albert Einstein College of Medicine-Beth Israel Medical Center, Union Square East, Suite 2M, New York, NY 10003, United States. [email protected]

Telephone: +1-212-8448570 Fax: +1-212-8448440
Received: May 28, 2013
Revised: July 11, 2013
Accepted: July 18, 2013
Published online: September 21, 2013

Abstract

Cholecystectomy is a common procedure. Abnormalities in the anatomy of the biliary system are common but an abnormal location of the gallbladder is much rarer. Despite frequent pre-operative imaging, the aberrant location of the gallbladder is commonly discovered at surgery. This article presents a case of a patient with the gallbladder located to the left of the falciform ligament in the absence of situs inversus totalis that presented with right upper quadrant pain. A laparoscopic cholecystectomy was performed and it was noted that the cystic duct originated from the right side. The presence of a left sided gall bladder is often associated with various biliary, portal venous and other anomalies that might lead to intra-operative injuries. The spectrum of unusual positions and anatomical gallbladder abnormalities is reviewed in order to facilitate elective and emergent cholecystectomy as well as other hepatobiliary procedures. With proper identification of the anatomy, minimally invasive approaches are still considered safe.

Key Words: Left sided gallbladder, Laparoscopic cholecystectomy, Sinistroposition of the gallbladder, Situs inversus, Bile duct anomaly, Liver anomalies, Portal vein anomaly, Liver transplant

Core tip: In the absence of situs inversus, left sided gallbladders are rare anomalies. They are most commonly encountered during surgery as they usually present with right sided pain and routine preoperative testing fails to identify them. Various biliary, portal venous and other anomalies are associated with left sided gallbladders and their spectrum is reviewed in this article. Recognition of these associated anomalies will help achieve safety in hepatobiliary procedures and prevent injuries.

Citation: Iskandar ME, Radzio A, Krikhely M, Leitman IM. Laparoscopic cholecystectomy for a left-sided gallbladder. World J Gastroenterol 2013; 19(35): 5925-5928