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Laparoscopic cholecystectomy for left-sided gallbladder

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Abstract

Purpose

Left-sided gallbladder (LSGB) is a rare congenital anomaly in the gallbladder, which is defined as a gallbladder located on the left side of the falciform ligament without situs inversus. We retrospectively analyzed 13 patients diagnosed with LSGB in a single center to confirm the safety of laparoscopic cholecystectomy (LC) and reviewed the anatomical implications in those patients.

Methods

Of the 4910 patients who underwent LC for the treatment of gallbladder disease between August 2007 and December 2019, 13 (0.26%) were diagnosed as having LSGB. We retrospectively analyzed these 13 patients for general characteristics, perioperative outcomes, and other variations through the perioperative imaging workups.

Results

All patients underwent LC for gallbladder disease. In all cases, the gallbladder was located on the left side of the falciform ligament. The operation was successfully performed with standard four-trocar technique, confirming “critical view of safety (CVS)” as usual without two cases (15.4%). In one case, which had an intraoperative complication and needed choledochojejunostomy because of common bile duct injury, there was an associated variation with early common bile duct bifurcation. The other patient underwent an open conversion technique because of severe fibrosis in the Calot’s triangle. Furthermore, on postoperative computed tomography, abnormal intrahepatic portal venous branching was found in all cases.

Conclusions

Although LSGB is usually encountered by chance during surgery, it can be successfully managed through LC with CVS. However, surgeons who find LSGB have to make efforts to be aware of the high risk of bile duct injury and possibility of associated anomalies.

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Authors and Affiliations

  1. Department of Surgery, College of Medicine, Hanyang University, Wansimni-ro 222, Seongdong-gu, Seoul, 04763, Republic of Korea

    Yun Kyung Jung, Dongho Choi & Kyeong Geun Lee

Authors
  1. Yun Kyung Jung
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  2. Dongho Choi
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  3. Kyeong Geun Lee
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Corresponding author

Correspondence to Kyeong Geun Lee.

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Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This retrospective study was approved by the Institutional Review Board (IRB) of the Hanyang University Hospital, Seoul, Republic of Korea, and all research conducted adhered to the tenets of the Declaration of Helsinki (IRB No. 2018-09-019).

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Not applicable.

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The authors declare no competing interests.

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Jung, Y.K., Choi, D. & Lee, K.G. Laparoscopic cholecystectomy for left-sided gallbladder. Langenbecks Arch Surg 407, 207–212 (2022). https://doi.org/10.1007/s00423-021-02263-0

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  • DOI: https://doi.org/10.1007/s00423-021-02263-0

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