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Related Experiment Videos

What's right when the gallbladder's left? A case report.

D Gui1, S Magalini, F Prete

  • 1Department of Surgery, Catholic University, Policlinico Gemelli, Largo Agostino Gemelli 8, 00168, Rome, Italy. daniele.gui@rm.unicatt.it

Surgical Endoscopy
|June 27, 2002
PubMed
Summary

A rare left-sided gallbladder (LSG) was incidentally found during surgery for gallstones. Surgeons must recognize this anomaly and its potential for unpredictable bile duct connections to prevent injury.

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Area of Science:

  • Surgical Anatomy
  • Gastrointestinal Surgery
  • Medical Imaging

Background:

  • Cholelithiasis is a common condition requiring surgical intervention, typically laparoscopic cholecystectomy.
  • Anatomical variations of the gallbladder and biliary tree can complicate surgical procedures.
  • Left-sided gallbladder (LSG) is a rare congenital anomaly with documented variations.

Observation:

  • A case of incidentally discovered left-sided gallbladder (LSG) during laparoscopic cholecystectomy for cholelithiasis is presented.
  • Two known anatomical variants of LSG include 'true LSG' involving accessory gallbladder and left hepatic duct anomalies, and gallbladder anomalies related to umbilical vein development.
  • The presented case involved a normal right-sided gallbladder adhering to the inferior left hepatic lobe with cystic duct drainage to the common bile duct (CBD).

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Findings:

  • Left-sided gallbladder (LSG) represents a paraphysiologic condition requiring careful pre-operative evaluation (CT/MRI) or intraoperative recognition.
  • Surgeons must be aware of the unpredictable confluence of the cystic duct into the CBD in cases of LSG.
  • Specific surgical precautions, including precise dissection, early cystic duct clipping, angled telescopes, and intraoperative cholangiography, are crucial for preventing common bile duct (CBD) injury.

Implications:

  • Prompt recognition and management of LSG during surgery are vital to avoid biliary complications.
  • Awareness of LSG variants enhances surgical safety in laparoscopic cholecystectomy.
  • Standard surgical protocols may need adaptation for rare anatomical variations like LSG to ensure patient safety.