True left-sided gallbladder (T-LSG) as incidental finding on laparoscopic cholecystomy - case report
Journal
Journal of Morphological Sciences
Date Issued
2021
Author(s)
Radomir Gelevski
Bojan Trencic
Abstract
Left
-
sided gallbladder, located medial
ly
t
o
the
falciform ligament, between segment III and IV
of the liver, has complex embryological development explained by two different concepts: one
founded upon f
o
etal migration of the
gallbladder
;
and
the other
founded upon complex f
o
etal
evolution of intrahepatic anatomy. 57
-
year
-
old male was admitted for elective cholecystectomy, and
,
after pneumoperitoneum was established
,
a
true left
-
sided gallbladder was identified.
The patient wa
s positioned in normal position and ports were placed on typical sites. After
diligent dissection, cystic artery and duct were clipped as close as possible to gallbladder and
dissected. During standard dissection in laparoscopic cholecystectomy, special at
tention
was
dedicated
to obtaining posterior critical view of safety, providing adequate exposition of structures of Calot’s
triangle.
Posterior critical view of safety in left
-
sided gallbladder exposes cardinal structures of hepatic
hilus. Although, duri
ng laparoscopy
,
difficult anatomy is met and there is high probability of bile duct
injury, laparoscopic cholecystectomy
is
the
recommended procedure of choice for left
-
sided
gallbladder.
-
sided gallbladder, located medial
ly
t
o
the
falciform ligament, between segment III and IV
of the liver, has complex embryological development explained by two different concepts: one
founded upon f
o
etal migration of the
gallbladder
;
and
the other
founded upon complex f
o
etal
evolution of intrahepatic anatomy. 57
-
year
-
old male was admitted for elective cholecystectomy, and
,
after pneumoperitoneum was established
,
a
true left
-
sided gallbladder was identified.
The patient wa
s positioned in normal position and ports were placed on typical sites. After
diligent dissection, cystic artery and duct were clipped as close as possible to gallbladder and
dissected. During standard dissection in laparoscopic cholecystectomy, special at
tention
was
dedicated
to obtaining posterior critical view of safety, providing adequate exposition of structures of Calot’s
triangle.
Posterior critical view of safety in left
-
sided gallbladder exposes cardinal structures of hepatic
hilus. Although, duri
ng laparoscopy
,
difficult anatomy is met and there is high probability of bile duct
injury, laparoscopic cholecystectomy
is
the
recommended procedure of choice for left
-
sided
gallbladder.