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First Report of Gallbladder Volvulus Managed with a Robotic Approach
Roberto Bustos1, Hassan Mashbari1, Antonio Gangemi1
1Division of General, Minimally Invasive and Robotic Surgery, Department of Surgery, University of Illinois at Chicago, 840 S. Wood Street, Suite 435E (MC 958), Chicago, IL 60612, USA.
Case Reports in Surgery
|August 10, 2019
Summary
Gallbladder volvulus, a rare twisting of the gallbladder, can be fatal if untreated. This case highlights successful robotic-assisted gallbladder removal after diagnosis during laparoscopy.
Area of Science:
- Gastroenterology
- Surgical Innovation
- Abdominal Imaging
Background:
- Gallbladder volvulus (GV) is a rare but potentially fatal condition involving axial twisting of the gallbladder.
- Untreated GV carries a mortality rate of up to 6% and often mimics acute cholecystitis.
- Diagnosis is frequently made intraoperatively due to overlapping clinical presentations.
Observation:
- An 81-year-old female presented with acute right upper quadrant pain and nausea, initially treated for acute cholecystitis based on ultrasound findings.
- Robotic-assisted cholecystectomy was planned, with GV diagnosed during the initial diagnostic laparoscopy.
- Indocyanine green fluorescence was utilized to confirm biliary anatomy post-resection.
Findings:
- Gallbladder volvulus was confirmed intraoperatively via laparoscopy.
- Successful and uneventful robotic-assisted cholecystectomy was performed.
- The patient experienced an uncomplicated postoperative course and was discharged on postoperative day 2.
Implications:
- This case demonstrates the successful management of gallbladder volvulus using a minimally invasive robotic approach.
- Early diagnosis and surgical intervention are crucial for favorable outcomes in GV.
- Robotic surgery and advanced imaging techniques like ICG fluorescence enhance surgical precision and patient recovery.
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