Laparoscopic Left Hepatic Lobe Cholecystectomy

Abstract

Left sided gallbladders are rare and this case describes cholecystectomy without additional port placement.

Left‐sided gallbladder: a systematic review of a rare biliary anomaly

“…59,60 Several studies described the use of operative cholangiography (OC) to confirm that the anatomy was correctly interpreted. 2,25,27,58 Of concern, four reports described a laparoscopic 'fundus first' dissection. 10,14,37,57 Of the 90 cholecystectomies performed for symptomatic gallstones, four (4.4%) had a CBD injury; three were during LC and one at open.…”

“…This is the most common variation of cystic duct union. 15 2012 South Africa 1 Almodhaiberi et al 16 2015 Korea 1 Asonuma et al 17 1999 Japan 4 Banzo et al 18 1989 Spain 1 Bender et al 7 2007 USA 1 Bonomo et al 8 2014 USA 1 Chrungoo et al 9 2007 India 2 Chuang 19 1976 USA 1 Chung et al 20 1997 Hong Kong 1 Colovic et al 10 2006 Serbia 1 Demirci et al 21 1990 Turkey 1 Dhulkotia et al 22 2002 India 2 Donthi et al 23 2001 USA 1 Hasbahceci et al 2 2013 Turkey 1 Herrington 24 1966 USA 1 Hopper et al 25 2003 Wales 1 Hsu et al 26 2007 China 9 Hwang et al 3 2004 Korea 3 Idu et al 27 1996 Scotland 5 Ikoma et al 28 1992 Japan 1 Iskandar et al 29 2013 USA 1 Jung et al 30 2009 Korea 1 Kanazumi et al 12 2007 Japan 2 Kawai et al 31 2011 Japan 1 Kehr 32 1902 Germany 1 Kelly and Craik 33 2008 England 1 Kim et al 34 2010 Korea 4 Makni et al 35 2011 Tunisia 1 Matsumoto et al 36 2008 Japan 1 Matsumura et al 37 2009 Japan 1 McGowan et al 38 1948 USA 1 Moo-Young et al 39 2009 USA 1 Moravik 40 2015 Czech Republic 1 Mulvey et al 41 2004 Australia 3 Nagai et al 42 1997 Japan 3 Naganuma et al 43 1998 Japan 4 Namikawa et al 44 2015 Japan 1 Newcombe and Henley 45 1964 England 1 Ozeki et al 46 1987 Japan 1 Qureshi and Awad 47 2009 USA 1 Reddy et al…”

“…First is the alteration of port position with a right‐hand surgeon's port beneath the left costal margin with the option of an additional left subcostal port . Second are the operative techniques to the falciform ligament, either to retract on the falciform ligament (with or without division) or the division of the falciform ligament and dissection off the left liver …”

“…15,58 Second are the operative techniques to the falciform ligament, either to retract on the falciform ligament (with or without division) 2,27 or the division of the falciform ligament and dissection off the left liver. 25 The variations in the technique described above improve only instrumentation and exposure. The key to safe dissection is the dissection technique used.…”

Left-Sided Gallbladder: Uncommon Presentation and Laparoscopic Approach

“…A laparoscopic approach to cholecystectomy has been successful, with several proposed modifications to surgical technique. One approach used a traditional right-side port placement, with a window created in the falciform ligament to access the left side (Hopper, Ryder, Swarnkar, & Stephenson, 2003). Anterograde dissection-a "dome down" approach via laparoscopy-has also been proposed (dissecting from the fundus), as is traditionally done with open cholecystectomy (Schiffino, Mouro, Levard, & Dubois, 1993).…”