Article Abstract

A common procedure with a rare anatomical finding: a case report on a true left-sided gallbladder

Authors: Kees de Mooij, Maikel Bakens, Erik de Loos, Jan Stoot

Abstract

Left-sided gallbladders (LSG) are a rare group of congenital anomalies that are mainly discovered intraoperatively. The gallbladder can be situated on the left side in case of situs inverses or an abnormally right placed ligamentum teres hepatis. A true LSG (T-LSG) with no further congenital variation is a more infrequent presentation with a prevalence of 0.04–0.30%. We present a case report of a middle-aged woman with abdominal symptoms suggestive for cholecystolithiasis. While ultrasonography confirmed the diagnosis, it failed to diagnose the T-LSG preoperatively and thus no further imaging was performed. During the laparoscopic cholecystectomy the congenital anomaly was found but no surgical modifications were needed to guarantee an uneventful removal of the T-LSG. Postoperatively the patient was discharged the same day, no histological abnormalities were reported. Clinical symptoms in the case of a T-LSG do not differ from a normally positioned gallbladder; moreover, the variation is often missed on imaging. Upon finding a T-LSG intraoperatively surgeons can alter their port placement or patient positioning to ensure a better critical view of safety, we report a case in which these adjustments were not necessary to safely remove the gallbladder. However, surgeons should be aware of the altered biliary anatomy associated with T-LSG and adjust the procedure to their own preference in order to safely remove the gallbladder without the occurrence of intra- or postoperative complications.