2016, Number 4
Laparoscopic cholecystectomy in cholecystitis with incidental Left-sided gallbladder. Two case report
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ABSTRACTObjective: To present two cases of left-sided gallbladder as well as a review of the literature available today. Case presentation: Case 1. 64 year old male with right upper quadrant pain with two hour duration, which diminishes after administrating unspecified NSAIDs. The upper abdominal ultrasound shows a gallbladder with a polyp and multiple small stones, without any radiologic evidence of anomalous gallbladder implanting. During laparoscopic cholecystectomy we identify a left-sided gallbladder. Case 2. 33-year-old female patient with history of being 16 weeks pregnant, is admitted with an eigth hour abdominal pain in the right upper quadrant which irradiates to the back. Abdominal ecography scan shows a gallbladder with multiple gallstones, a 4mm wall, perivesicular liquid collections and dilation of intrahepatic ducts, but not a left-sided gallbladder implanting. Antibiotics and analgesics are started and three days later, she undergoes laparoscopic cholecystectomy. During the procedure, we identify a gallbladder implanted on the left side of the round ligament. The patient had an adequate evolution and was discharged three days later. Conclusion: The presence of an ectopic gallbladder located under the left lobe of the liver without situs inversus totalis is known as a left-sided gallbladder, and found in 0.3 to 1% of total population, usually transoperatively. We present two cases and a revision of the literature currently available.
Dhulkotia A, Kumar S, Kabra V, Shukla HS. Aberrant gallbladder situated beneath the left lobe of liver. HPB (Oxford). 2002; 4: 39-42.
Hochstetter F. Anomaliem der Pfortader und der Nabelvene in verbindung mit Defect oder Linkscage der Gall-en-blasé. Archiv für mikroskopische Anatomie und Entwicklungsgeschichte, 1886, pp. 369-384.
Hsu SL, Chen TY, Huang TL, Sun CK, Concejero AM, Tsang LL, Cheng YF. Left-sided gall bladder: Its clinical significance and imaging presentations. Worold J Gastroenterol. 2007; 13: 6404-6409.
Nagai M, Kubota K, Kawasaki S, Takayama T, Bandai Y, Makuuchi M. Are left-sided gallbladders really located on the left side? Ann Surg. 1997; 225: 274-280.
Newcombe JF, Henley FA. Left-Sided Gallbladder. A review of the literature and a report of a case associated with hepatic duct carcinoma. Arch Surg. 1964; 88: 494-497.
Qureshi I, Awad Z. Aberrant presentation of the gallbladder during laparoscopic cholecystectomy. JSLS. 2009; 13: 605-607.
Zografos G, Lagoudianakis E, Grosomanidis D, Koronakis N, Tsekouras D, Chrysikos J, et al. Management of incidental left-sided gallbladder. JSLS. 2009; 13: 273-275.
Matsumura N, Tokumura H, Yasumoto A, Sasaki H, Yamasaki M, Musuya H, et al. Laparoscopic cholecystectomy and common bile duct exploration for cholecystocholedocholithiasis with a left-sided gallbladder: report of a case. Surg Today, 2009; 39: 252-255.
Zango BA, Morales SP, Raimundo MG, Pinillos JL, Paulino AM, Nácher JB. Correct placement of left-sided double lumen endotracheal tubes: a simple verification technique. Rev Esp Anestesiol Reanim. 2008; 55: 277-281.