Left-sided Gallbladder in the Era of Laparoscopic Cholecystectomy: A Single-center Experience

The malposition of gallbladder under the liver segment III, defined as left-sided gallbladder (LSG), is an unexpected situation for the laparoscopic surgeon. The purpose of this study is to present our experience in treating patients with cholecystitis and LSG discovered incidentally during laparosc...

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Bibliographic Details
Published in:The American surgeon 2015-12, Vol.81 (12), p.1249-1252
Main Authors: Velimezis, Georgios, Vassos, Nikolaos, Kapogiannatos, Georgios, Koronakis, Dimitrios, Salpiggidis, Christos, Perrakis, Evangelos, Perrakis, Aristotelis
Format: Article
Language:English
Subjects:
Abdomen
Adult
Aged
Bile
Cholecystectomy
Cholecystectomy, Laparoscopic - methods
Cholelithiasis - complications
Cholelithiasis - epidemiology
Cholelithiasis - surgery
Dissection
Endoscopy
Female
Follow-Up Studies
Gallbladder
Gallbladder - abnormalities
Gallbladder - surgery
Gallbladder diseases
Gallbladder Diseases - complications
Gallbladder Diseases - epidemiology
Gallbladder Diseases - surgery
Germany - epidemiology
Hospitals
Humans
Incidence
Laparoscopy
Ligaments
Liver
Male
Middle Aged
Mortality
Pain
Phosphatase
Retrospective Studies
Time Factors
Treatment Outcome
Ultrasonic imaging
Veins & arteries
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Summary:The malposition of gallbladder under the liver segment III, defined as left-sided gallbladder (LSG), is an unexpected situation for the laparoscopic surgeon. The purpose of this study is to present our experience in treating patients with cholecystitis and LSG discovered incidentally during laparoscopic surgical procedure. Between 1993 and 2009, 5569 patients underwent laparoscopic cholecystectomy in our surgical department. Their records were reviewed and seven patients revealed having LSG (0.12%). Analysis parameters included demographic data, diagnostic methods, mode of surgery, and postoperative outcome. Mean follow-up was 140 months. Of the seven patients, five were women. Mean patient age was 56.7 years. All patients were referred to our department with clinical symptoms of classic cholelithiasis and the diagnosis was established in all of them during surgery. Laparoscopic cholecystectomy was successful in five patients, while in two patients, a conversion to open procedure was needed. A postoperative complication, i.e., biliary leakage was registered in one patient, which was treated successfully. Laparoscopic cholecystectomy is safe even in LSG, but the surgeon must consider the possibility for more anatomical anomalies, adjust the technique of dissection, and must not hesitate, if in doubt, to strive for conversion to open procedure to avoid serious complications.
ISSN:0003-1348
1555-9823
DOI:10.1177/000313481508101227