Bhati G, Capolupo GT, Bhati K, Gupta A, Bansal R, Sai Srinija P, Caricato M, Carannante F. Laparoscopic cholecystectomy in patients with situs inversus totalis: Two case reports and review of literature. World J Clin Cases 2026; 14(12): 118091 [DOI: 10.12998/wjcc.v14.i12.118091]
Corresponding Author of This Article
Filippo Carannante, PhD, Academic Fellow, Additional Professor, FACS, Unità Operativa Complessa Chirurgia Colorettale, Fondazione Policlinico Campus Bio-Medico, Via Alvaro del Portillo 200, Roma 00128, Italy. f.carannante@unicampus.it
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Surgery
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Case Report
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Apr 26, 2026 (publication date) through Apr 15, 2026
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World Journal of Clinical Cases
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Bhati G, Capolupo GT, Bhati K, Gupta A, Bansal R, Sai Srinija P, Caricato M, Carannante F. Laparoscopic cholecystectomy in patients with situs inversus totalis: Two case reports and review of literature. World J Clin Cases 2026; 14(12): 118091 [DOI: 10.12998/wjcc.v14.i12.118091]
World J Clin Cases. Apr 26, 2026; 14(12): 118091 Published online Apr 26, 2026. doi: 10.12998/wjcc.v14.i12.118091
Laparoscopic cholecystectomy in patients with situs inversus totalis: Two case reports and review of literature
Gajendra Bhati, Gabriella Teresa Capolupo, Kamna Bhati, Akshansh Gupta, Raghav Bansal, Polishetti Sai Srinija, Marco Caricato, Filippo Carannante
Gajendra Bhati, Department of Surgical Gastroenterology and Hepatopancreatobiliary Surgery, Adesh Institute of Medical Sciences and Research, Bathinda 151001, Punjab, India
Gabriella Teresa Capolupo, Marco Caricato, Filippo Carannante, Unità Operativa Complessa Chirurgia Colorettale, Fondazione Policlinico Campus Bio-Medico, Roma 00128, Italy
Kamna Bhati, Department of Dietetics, All India Institute of Medical Sciences and Research, Bathinda 151001, Punjab, India
Akshansh Gupta, Department of Surgical Gastroenterology, Adesh Institute of Medical Sciences and Research, Bathinda 151001, Punjab, India
Raghav Bansal, Department of General Surgery, Adesh Institute of Medical Sciences and Research, Bathinda 151001, Punjab, India
Polishetti Sai Srinija, Sri Venkata Sai Medical College, Kaloji Narayana Rao University of Health Sciences, Telangana 509001, India
Co-corresponding authors: Raghav Bansal and Filippo Carannante.
Author contributions: Bhati G and Carannante F contributed equally to this manuscript and are co-corresponding authors. Bhati G and Bansal R were involved in patient management and surgical treatment; Caricato M and Capolupo GT provided surgical supervision and critical clinical input; Bhati K, Gupta A, and Srinija S collected clinical data and performed the literature review; Carannante F conceived and designed the study, critically revised the manuscript for important intellectual content, and approved the final version. All authors read and approved the final manuscript.
Informed consent statement: Written informed consent was obtained from the patient for their participation in the study and for the publication of their clinical information and images. No identifiable patient information is included in this publication.
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: Filippo Carannante, PhD, Academic Fellow, Additional Professor, FACS, Unità Operativa Complessa Chirurgia Colorettale, Fondazione Policlinico Campus Bio-Medico, Via Alvaro del Portillo 200, Roma 00128, Italy. f.carannante@unicampus.it
Received: December 25, 2025 Revised: February 4, 2026 Accepted: March 19, 2026 Published online: April 26, 2026 Processing time: 112 Days and 8.3 Hours
Abstract
BACKGROUND
Situs inversus totalis (SIT) is a rare congenital anomaly characterized by complete mirror-image transposition of thoracic and abdominal organs. The presence of gallstone disease in these patients represents a diagnostic and technical challenge, particularly when laparoscopic cholecystectomy is indicated.
CASE SUMMARY
We report two cases of symptomatic gallstone disease in patients with SIT. The first case involved a 27-year-old female diagnosed with cholelithiasis following radiological evaluation, while the second case involved a 45-year-old male presenting with cholelithiasis and choledocholithiasis requiring preoperative endoscopic retrograde cholangiopancreatography. Cases were identified retrospectively from institutional surgical records. Data were collected from clinical charts, imaging studies, operative reports, and follow-up visits. In both patients, laparoscopic cholecystectomy was successfully performed using a mirror-image port placement strategy. No intraoperative or postoperative complications occurred, and both patients were discharged on the first postoperative day.
CONCLUSION
Laparoscopic cholecystectomy in patients with SIT is safe and feasible when meticulous preoperative imaging and careful adaptation of surgical technique are employed. Awareness of mirror-image anatomy and strict adherence to the critical view of safety are essential to minimize the risk of iatrogenic injury.
Core Tip: Situs inversus totalis is a rare anatomical condition that presents unique diagnostic and technical challenges during laparoscopic cholecystectomy. This case series emphasizes the importance of thorough preoperative imaging to clearly define biliary anatomy and identify any associated anomalies. It also highlights the need for careful adaptation of surgical technique, including mirror-image port placement and ergonomic adjustments by the surgical team. Strict adherence to the critical view of safety remains essential to minimize the risk of bile duct injury and to ensure safe, effective, and reproducible surgical outcomes.
