Published online Sep 21, 2013. doi: 10.3748/wjg.v19.i35.5925
Revised: July 11, 2013
Accepted: July 18, 2013
Published online: September 21, 2013
Processing time: 116 Days and 1.6 Hours
Cholecystectomy is a common procedure. Abnormalities in the anatomy of the biliary system are common but an abnormal location of the gallbladder is much rarer. Despite frequent pre-operative imaging, the aberrant location of the gallbladder is commonly discovered at surgery. This article presents a case of a patient with the gallbladder located to the left of the falciform ligament in the absence of situs inversus totalis that presented with right upper quadrant pain. A laparoscopic cholecystectomy was performed and it was noted that the cystic duct originated from the right side. The presence of a left sided gall bladder is often associated with various biliary, portal venous and other anomalies that might lead to intra-operative injuries. The spectrum of unusual positions and anatomical gallbladder abnormalities is reviewed in order to facilitate elective and emergent cholecystectomy as well as other hepatobiliary procedures. With proper identification of the anatomy, minimally invasive approaches are still considered safe.
Core tip: In the absence of situs inversus, left sided gallbladders are rare anomalies. They are most commonly encountered during surgery as they usually present with right sided pain and routine preoperative testing fails to identify them. Various biliary, portal venous and other anomalies are associated with left sided gallbladders and their spectrum is reviewed in this article. Recognition of these associated anomalies will help achieve safety in hepatobiliary procedures and prevent injuries.