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Laparoscopic Cholecystectomy and Common Bile Duct Exploration in Situs Inversus Patients
S Simkhada1, B Malla1, R Shrestha1
1Department of Surgery, Dhulikhel Hospital, Kathmandu University Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal.
Kathmandu University Medical Journal (KUMJ)
|November 25, 2021
Summary
Laparoscopic cholecystectomy in patients with situs inversus, a rare congenital condition, presents unique surgical challenges. Successful outcomes are achievable with careful planning and adaptation to the mirrored anatomy.
Area of Science:
- Surgical Gastroenterology
- Congenital Anomalies
Background:
- Situs inversus is a congenital condition with reversed visceral organ positioning, affecting 1 in 5,000-20,000 births.
- Gallbladder stone disease incidence is similar in situs inversus patients and the general population.
Purpose of the Study:
- To report on the successful laparoscopic management of gallstone disease in patients with situs inversus.
- To highlight the technical challenges and necessary adaptations for performing laparoscopic cholecystectomy in situs inversus.
Main Methods:
- Case reports of two patients (54-year-old male, 63-year-old female) with gallstones and situs inversus.
- Laparoscopic cholecystectomy performed with port placement adjusted for the mirrored anatomy (liver and gallbladder on the left).
Main Results:
- Both patients underwent successful laparoscopic cholecystectomy without perioperative complications.
- Surgical dissection was challenging due to the need for non-dominant hand use by a right-handed surgeon.
Conclusions:
- Laparoscopic cholecystectomy in situs inversus is technically demanding but feasible.
- Requires meticulous surgical orientation and adaptation to the left-sided abdominal viscera.
