A case of laparoscopic cholecystectomy for a left-sided gallbladder, diagnosed intraoperatively Hideyasu SAKIHAMA 1 , Ryoichi YOKOTA 1 , Shoji YAMAGA 1 , Eisuke NAGABUCHI 1 , Hiroshi KURIBAYASHI 1 1Department of Surgery, Nakashibetsu Municipal Hospital Keyword: 左側胆囊 , 腹腔鏡下胆囊摘出術 , 門脈分岐異常 pp.625-630
Published Date 2008/10/15
DOI https://doi.org/10.11477/mf.4426100272
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 We report a case of left-sided gallbladder combined with an anomaly of the intrahepatic portal vein. A 39-year-old woman underwent laparoscopic cholecystectomy for symptomatic cholecystolithiasis. Intraoperative finding showed that the gallbladder was located under the left hepatic segments at the left of the hepatic round ligament. We used four ports placed in the infraumbilical region, the epigastric region, the right midclavicular region and the right anterior axillary line in the usual manner. The movement of laparoscopic forceps were strikingly restricted because of inappropriate places of four ports inserted for left-sided gallbladder, we had difficulty in the identification and the dissection of the cystic duct and the cystic artery and the removal of the gallbladder from the hepatic bed. A retrospective analysis of abdominal computed tomography(CT)and magnetic resonance imaging(MRI)revealed the right hepatic round ligament and the gallbladder lying to the left of the right hepatic round ligament. From our experience, we reviewed 25 cases including our case in the Japanese literature concerning left-sided bladders removed laparoscopically, in terms of anomalies of portal vein, places where cystic ducts terminated, places of gallbladder fossa and special procedures.

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