True left-sided gallbladder (T-LSG) as incidental finding on laparoscopic cholecystomy - case report

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.