Clinical significance and characteristics of left-sided gallbladder: case series study of 10 patients

Abstract

PurposeThe aims of this case series study were to review the 10 patients who were diagnosed with left-sided gallbladder and analyze their anatomic variations in the bile duct, portal vein, and hepatic vessels.MethodsIn this case series study, 10 patients with left-sided gallbladder were retrospectively analyzed at 2 tertiary referral centers between April 2004 and May 2019.ResultsMean age was 61.1 years; there were 7 women and 3 men. Ten patients underwent laparoscopic cholecystectomy for acute cholecystitis or symptomatic gallbladder stone. The mean operation time was 77.2 minutes. Three ports were used in laparoscopic cholecystectomy procedures. The mean postoperative hospital stay was 3.5 days, and there were no cases of surgery-related morbidity. Two patients had type 1 bile duct and 3 had type 3 bile duct (2 type 3B and 1 type 3A). The right posterior portal vein as the first branch of the main portal vein was observed in all patients. Segment IV branches of the left portal vein crossing over to the segment VIII territory were observed in 7 of the 10 patients.ConclusionAlthough left-sided gallbladder is a very rare disease, it is possible to diagnose it preoperatively and perform laparoscopic cholecystectomy safely by adjusting port position. The common important features of left-sided gallbladder include distribution of the left portal vein crossing over to the right side of the liver and increased size of the left portal vein. These variations may have important clinical implications in the management of hepatic resection including donor hepatectomy.

Left-sided gallbladder ‘sinistroposition’ associated with an anatomical variant of cystic duct insertion: case report

“…True LSGB is a rare anatomical anomaly with an incidence rate of 0.1–1.2% and a rate of 0.07–0.08% in patients undergoing cholecystectomy. It occurs more frequently in women than in men at a ratio of 5:1 [ 2 , 4 ].…”

“…Lee et al . reported that the median surgery time is 50 min (range, 35–160 min), which is less than that indicated by Jung et al ., who reported an operation time of 103 min (range, 65–240 min) [ 2 , 4 , 5 , 8 ].…”

Stone removal in a 5‐year‐old child with extrahepatic biliary obstruction usingERCP: A case report and a mini‐review

“…These variations probably have considerable clinical implications in managing hepatic resection, including donor hepatectomy. 19 In recent years, the treatment approaches for managing choledocholithiasis in children have become more specific; however, no gold standard procedure is available yet. The endoscopic approach for managing biliary tract obstruction in medical centers performing ERCP is usually the first choice.…”

Stone removal in a five-year-old child with extrahepatic biliary obstruction using ERCP: A case report and a mini-review

“…Increased size of the left portal vein and distribution of the left portal vein crossing over to the right side of the liver is the crucial common features of the left-sided gallbladder. These variations probably have considerable clinical implications in managing hepatic resection, including donor hepatectomy (17).…”