J Korean Surg Soc.  2008 Jun;74(6):459-461.

Laparoscopic Cholecystectomy in Patients with a Left-sided Gallbladder

• Joo SH
• Lee S
• Kim JS

Abstract

Laparoscopic cholecystectomy has been widely performed as the gold standard for patients suffering with symptomatic gallstone disease. However, conversion to open cholecystectomy is a dilemma when the surgeon encounters a variant biliary anomaly. A gallbladder lying to the left of the round ligament represents a rare congenital anomaly, which is termed as a left-sided gallbladder. The true left-sided gallbladder, situated on the inferior aspect of the left lobe of the liver, is extremely rare and this represents a truly ectopic gallbladder that may developmentally arise as a second gallbladder from the left hepatic duct. This is accompanied by the disappearance of the normal gallbladder on the right side. We report here on 2 cases of left-sided gallbladder that were successfully treated with laparoscopic cholecystectomy at Hallym Medical Center. In both cases, the true left-sided gallbladders were identified intraoperatively. The round ligament was indeed located in its normal position, and the gallbladder was located to the left of the round ligament, which is a type of malposition known as sinistroposition. The operation was carried out in the usual manner with the trocars placed their usual location. Although operations can be carried out with using the standard port sites, a better arrangement for laparoscopic cholecystectomy consists of more medial positioning of the gallbladder-retracting port and placement of the right hand operating port to the left side of the round ligament.

Keyword

Laparoscopic cholecystectomy; Left-sided gallbladder

MeSH Terms

Cholecystectomy
Cholecystectomy, Laparoscopic
Deception
Gallbladder
Gallbladder Diseases
Gallstones
Hand
Hepatic Duct, Common
Humans
Liver
Round Ligament of Uterus
Round Ligaments
Stress, Psychological
Surgical Instruments
Gallbladder
Gallbladder Diseases