A case report on a left sided gallbladder: A rare finding during cholecystectomy

Cholecystectomy is the surgical removal of gallbladder for symptomatic gallstones disease or where exist the risk of gallbladder malignancy. Its performed routinely across the globe often as day surgery. In this case report, we describe an incidental intra operative finding of a left sided gallbladder creating a technical challenge for the surgeon.

We describe the case of 35 year old female who presented with RUQ pain. Ultrasound examination revealed gallstones. Intraoperative findings during routine cholecystectomy were of a left sided gallbladder. The surgical procedure in performing laparoscopic surgery required an extra port placement for safe and effective dissection.

The finding of left sided gallbladder is a rare congenital anomaly and has a prevalence of 0.1-0.7%. A true left sided gallbladder is one that is found to the left of the ligamentum teres and falciform ligament and the cystic artery always crosses in front of the CBD from right to left. There are various abnormalities associated this anatomical variant from abnormality of the biliary tree to the porto-venous anatomy. Failure to recognise these variations can lead to serious complications especially in hepatobiliary surgery.

The finding of left sided gallbladder is an abnormality which is often discovered intraoperatively. It may provide the surgeon with operative challenges in performing the surgery safely and increase the incidence of morbidity. If there is any clinical suspicion of the presence of a left sided gallbladder, pre-operative CT angiography and/or intraoperative cholangiography should be performed to minimise the risk of intraoperative complications.