Left-sided gallbladder: an incidental finding on laparoscopic cholecystectomy.

Area of Science:

• Gastroenterology
• Surgical Anatomy
• Medical Imaging

Background:

• Transposition of the gallbladder to the left side, without complete situs inversus, is an uncommon congenital anomaly.
• This anatomical variation typically positions the gallbladder beneath the left lobe of the liver, near segments III and IV or to the left of the falciform ligament.

Observation:

• A 50-year-old woman presented with right upper quadrant abdominal pain.
• Initial examination revealed tenderness without a Murphy's sign; ultrasonography confirmed gallstones but no bile duct dilation.

Findings:

• Laparoscopic cholecystectomy revealed a left-sided gallbladder, located left of the round ligament.
• Intraoperative cholangiography demonstrated no bile duct dilation or other congenital biliary anomalies, confirming successful gallbladder excision.

Implications:

• This anomaly may evade routine preoperative detection, potentially surprising surgeons during laparoscopic procedures.
• Awareness of atypical cystic duct confluence and judicious use of intraoperative cholangiography are crucial for safe management.
• This case underscores the need for vigilance in identifying and managing rare anatomical variations in biliary surgery.