Gallbladder volvulus is a rare but well recognized entity with approximately 300 cases documented in the literature since 1898. Eighty-five percent of cases occur in the elderly with three times as many women being affected. It is characterized by a generous peritoneal investment of the gallbladder and long, tortuous cystic duct which allows for the development of an abnormally “long mesentery” suspending the gallbladder from the liver bed. Subsequent to this development, volvulus occurs using the cystic duct and mesentery as the point of torsion.
We present a video of successful laparoscopic detorsion and cholecystectomy in a 91 year-old woman. In addition to the events leading up to operative intervention, the literature regarding gallbladder volvulus is reviewed. The technical points leading to successful laparoscopic cholecystectomy in this patient are discussed.
Because of the rarity of this condition, preoperative identification is often not apparent. Regardless, gallbladder volvulus can and should be managed laparoscopically. The information presented in this video can serve as a guide for management of this disease entity using minimally invasive techniques.
Session: Video Channel
Program Number: V058
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