Acute cholecystitis in a left sided gallbladder safely managed by laparoscopic surgery

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Agustín Virgili
Carlos Wendichansky
Rodrigo Maroni

Abstract

Left-sided gallbladder (LSGB) is a rare bile duct  abnormality, usually found during a cholecystectomy.
Symptoms usually do not differ from those of a normally positioned gallbladder, making the preoperative diagnosis extremely uncommon. We report the case of an acute cholecystitis in a patient whit LSGB, safely managed with laparoscopic surgery. A 24-year-old male patient was admitted to our institution with clinical and radiological signs of acute cholecystitis. The intraoperative finding of
an acute cholecystitis in a LSGB made us modify ports positioning and a cholangiograhy was done by direct puncture of the gallbladder before hilum dissection. After the cystic duct was identified, a transcystic cholangiography was performed which confirmed a complete and clear bile duct anatomy and laparoscopic cholecystectomy was safely completed. The intraoperative finding of a LSGB makes the surgeon change some aspects of the usual technique to perform a safe cholecystectomy as LSGB significantly increases the risk of common bile duct injuries. Meticulous dissection of the gallbladder hilum to achieve a critical view of safety and the systematic use of intraoperative cholangiography are extremely important to perform a safe laparoscopic cholecystectomy

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How to Cite
Virgili, A., Wendichansky, C., & Maroni, R. (2021). Acute cholecystitis in a left sided gallbladder safely managed by laparoscopic surgery. Revista Argentina De Cirugía, 113(1), 125–130. https://doi.org/10.25132/raac.v113.n1.1490.ei
Section
Scientific Letter