TRUE LEFT-SIDED GALLBLADDER (T-LSG) AS INCIDENTAL FINDING ON LAPAROSCOPIC CHOLECYSTOMY â€“ CASE REPORT

Radomir Gelevski; Gjorgi Jota; Lazar Todorovic; Gjorgi Trajkovski; Vladimir Joksimovic; Bojan Trencic; Ljubomir Ognjenovic

Radomir Gelevski General Hospital Kumanovo, R.of North Macedonia
Gjorgi Jota University Clinic for Digestive Surgery, Faculty of Medicine, Ss. Cyril and Methodius University Skopje, R. of North Macedonia
Lazar Todorovic University Clinic for Pediatric Surgery Faculty of Medicine, Ss. Cyril and Methodius University Skopje, R. of North Macedonia
Gjorgi Trajkovski University Clinic for Digestive Surgery, Faculty of Medicine, Ss. Cyril and Methodius University Skopje, R. of North Macedonia
Vladimir Joksimovic University Clinic for Digestive Surgery, Faculty of Medicine, Ss. Cyril and Methodius University Skopje, R. of North Macedonia
Bojan Trencic General Hospital Kumanovo, R.of North Macedonia
Ljubomir Ognjenovic University Clinic for Digestive Surgery, Faculty of Medicine, Ss. Cyril and Methodius University Skopje, R. of North Macedonia

Abstract

Left-sided gallbladder, located medially to the falciform ligament, between segment III and IV of the liver, has complex embryological development explained by two different concepts: one founded upon foetal migration of the gallbladder; and the other founded upon complex foetal 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 was 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 attention was dedicated to obtaining posterior critical view of safety, providing adequate exposition of structures of Calotâ€™s triangle. Posterior critical view of safety in left-sided gallbladder exposes cardinal structures of hepatic hilus. Although, during 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.

Key words: left-sided gallbladder, posterior critical view of safety.

https://doi.org/10.55302/JMS2141050g

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