Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Gastrointest Surg. Jun 27, 2026; 18(6): 119179
Published online Jun 27, 2026. doi: 10.4240/wjgs.119179
Published online Jun 27, 2026. doi: 10.4240/wjgs.119179
Posterior approach to Calot’s triangle in situs inversus totalis: A case report and review of literature
Mao-Lin Chen, Zhu-Lin Luo, Department of Hepatobiliary Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
Mao-Lin Chen, Xiao Ma, Le Xiao, Tian-Tian Chen, Zhu-Lin Luo, Xiao-Dong Xie, Department of General Surgery, The General Hospital of Western Theater Command, Chengdu 610083, Sichuan Province, China
Co-corresponding authors: Zhu-Lin Luo and Xiao-Dong Xie.
Author contributions: Chen ML designed the study and drafted the manuscript; Chen ML and Ma X contributed to the data collection, literature review, and data analysis; Ma X and Xie XD performed the surgical intervention; Ma X, Xiao L, Luo ZL, and Xie XD contributed to manuscript revision; Xiao L contributed to data interpretation; Chen TT collected case information, organized the imaging materials, and prepared the tables and figures; Luo ZL and Xie XD contributed equally as co-corresponding authors, providing overall supervision and critical revision. All authors approved the final manuscript.
AI contribution statement: During the preparation of this manuscript, the authors used ChatGPT only to translate portions of the text, correct grammar, and polish the language. The AI tool was not used to generate any academic content, nor was it involved in the study design, data analysis, interpretation of results, formulation of conclusions, or figure generation. After using the AI tool, the authors carefully reviewed, revised, and verified the relevant content. The authors take full responsibility for the academic content and views expressed in the manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Xiao-Dong Xie, PhD, Professor, Department of General Surgery, The General Hospital of Western Theater Command, No. 270 Rongdu Road, Jinniu District, Chengdu 610083, Sichuan Province, China. xiexiaodong10@yeah.net
Received: January 22, 2026
Revised: February 17, 2026
Accepted: March 23, 2026
Published online: June 27, 2026
Processing time: 150 Days and 5.8 Hours
Revised: February 17, 2026
Accepted: March 23, 2026
Published online: June 27, 2026
Processing time: 150 Days and 5.8 Hours
Core Tip
Core Tip: Mirror-image anatomy in situs inversus totalis can increase ergonomic and cognitive demands during laparoscopic cholecystectomy, particularly when Calot’s triangle dissection is challenging. We describe a posterior approach to Calot’s triangle as a stepwise access strategy in which a posterior window is developed and dissection proceeds in a posterior-to-anterior direction to facilitate sequential anatomic confirmation. This pathway may help limit instrument crossing and reduce the need for repeated reorientation in situs inversus totalis cases while maintaining adherence to the critical view of safety principles.