Kwang Yeol Paik, WonKyung Kang, Prof. Catholic University of Korea, Yeouido St. Mary’s Hosp
Introduction: The gallbladder (GB) placed in the left side (LS) of liver bed is a rare anatomy. This variation makes operator hard to perform cholecystectomy. Despite it is important to apprehend the detailed anatomy of bile duct and GB and understand how to approach LSGB in advance cholecystectomy, we usually encounter difficulties with this unusual situation just after begining operation. We herein report surgical process of LSGB with video in this manuscript.
Patients: The patient was following up with gallstones about ten years and occasionally complained of the pain migrating from Left upper quadrant to epigastric area. LSGB was encountered after begining laparoscope approach. Laparoscopic cholecystectomy was done antegrade method not to injure anomalous bile duct.
Results: To prevent the injury to anomalous bile duct, we began to carefully separate GB from its fundus first, prior to cystic duct ligation. Cholecystectomy was successfully done after complete detachment of GB from liver bed. Postoperative lab findings and patient’s condition showed little possibility of injury on surgical site. Patient was discharged two days after surgery.
Conclusion: When surgeon encounter LSGB without diagnosis prior to operation, Antegrade dissection of GB enables surgeons to detect Calot’s triangle easily and to complete operation safely. For unpredictable but possible anomalous GB, surgeon should always give a thought to suitably modified cholecystectomy.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 84752
Program Number: P118
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster
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