Single‐incision laparoscopic cholecystectomy for gallbladder torsion: A case report and literature review

Matsubara, Keiso; Urushihara, Takashi; Oshita, Akihiko; Itamoto, Toshiyuki

doi:10.1111/ases.12435

Cited by 8 publications

(5 citation statements)

References 7 publications

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“…In addition, the GT should be managed promptly by the surgical method after diagnosis (18,24). In recent reports, torsion was managed successfully by laparoscopy (5,7,25) and some surgeons have tried the single incision laparoscopic method (26). In our study, the laparoscopic approach was successful in total GT cases.…”

Section: Discussionsupporting

confidence: 52%

A comparative analysis of gallbladder torsion and acute gallbladder disease without torsion: a single-center retrospective case series study

2021

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Background: Acute gallbladder disease (AGD) is frequent in the emergency department (ED), and usually requires surgical intervention. Gallbladder torsion (GT) is a rare entity among patients with AGD. There are sparse reviews of GT's clinical characteristics, and there is no comparative study between them in the same patient cohort. Therefore, we report the case series of GT, and compare the statistical differences between GT and non-GT with AGD.Methods: We collected retrospective data from patients who visited ED with AGD and underwent emergency cholecystectomy between January 2005 and December 2020. We combined consecutive case series of GT and compared them with non-GT gallbladder disease.Results: Six GT cases were diagnosed over the study duration. Five were female (83%) and the average age was 77.8 years. All patients presented with abdominal pain, and the median duration of pain was two days.Only two cases were suspected for GT pre-operatively (33%). One patient underwent laparotomy, and the others underwent laparoscopic cholecystectomy with a mean operation time of 59 min. The torsion direction was of the same proportion in both directions; five (83%) were rotated completely. The mean length of hospital stay was 9.3 d and outcomes were favorable in most GT cases. In the comparative study between GT and non-GT, age was higher in the GT group (P=0.048), and duration or severity of pain showed no statistical difference (P=0.528; P=0.637, respectively). Body temperature was higher in the non-GT group without statistical significance (P=0.074). Gallstones were present in 68.8% of the non-GT group, which is significantly higher than that of the GT group (P=0.036).Conclusions: Six exceptional GT cases were managed successfully. The overall characteristics of each GT case demonstrated similar with previous reviews. Our comparative analysis showed that age, pulse rate, serum creatinine level, and gallstone presence showed statistical differences. Contrary to the traditional knowledge of GT, some distinct features like sex, duration or severity of pain, and fever showed no significant differences within AGD in our research.

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Section: Discussionsupporting

confidence: 52%

A comparative analysis of gallbladder torsion and acute gallbladder disease without torsion: a single-center retrospective case series study

2021

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“…Our department has done many cases of choledochal cyst and mesenteric cyst surgery in children, but because of the low incidence of GT in children, we have little knowledge about it. Previous studies ( 22 ) have shown that LC is a good option for the treatment of GT because there is less adhesion of the mobile mesentery to the gallbladder bed. In the last 10 years, only five pediatric cases of GT treated with LC have been reported in the English references ( Table 1 ).…”

Section: Discussionmentioning

confidence: 99%

Case report: Rare floating gallbladder torsion in a child

Ren,

Liu,

Liu

et al. 2024

Front. Med.

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Gallbladder Torsion (GT) refers to serious biliary emergencies caused by the torsion of the gallbladder on its mesentery along the axis of the cystic duct and cystic artery. It is very rare, especially in children. The clinical data of a child with floating gallbladder torsion who was treated in our hospital on March 14, 2024, were analyzed. A 6-year-old girl presented with abdominal pain and vomiting. Physical examination showed a mass in the right middle abdomen. Laboratory tests showed normal liver biochemical function and white blood cells. The benign lesion was considered by color Doppler ultrasound and CT, and the floating torsion of the gallbladder was diagnosed by MRCP and laparoscopic exploration. The child was treated with laparoscopic cholecystectomy (LC) and recovered well after the operation.

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“…Only a quarter to a half of patients with gallbladder torsion have gallstones, so gallstones are a concomitant condition and not likely to be the underlying etiology (1,5). According to the gross classification, gallbladder torsion can be divided into 2 classifications: one is that the gallbladder and cystic duct are suspended to the liver through the mesentery, while the other is that the cystic duct is connected to the liver alone (7,8). In our case, the classification corresponds to type I, and the gallbladder was attached to only a small part of the liver.…”

Section: Discussionmentioning

confidence: 99%

Acute abdominal disease associated with gallbladder torsion recovered after cholecystectomy: a rare case report and literature review

Wu¹,

Huang²,

He³

et al. 2022

Ann Transl Med

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Background: Gallbladder torsion is very rare and easily misdiagnosed as biliary disease. It is defined as the rotation of the gallbladder along the axis of the cystic pedicle on the mesentery. As gallbladder rotation involves the gallbladder artery, the blood supply is blocked, resulting in gallbladder ischemia and eventual necrosis. If misdiagnosis occurs and treatment is delayed, gallbladder torsion can develop into a lethal disease. The typical imaging features of gallbladder torsion in this case are a good learning resource for our young physicians, as well as providing a rare, unusual and typical case for our current literature database.Case Description: We present a rare case of gallbladder torsion in a 19-year-old man. The patient complained of sudden recurrent pain and discomfort in the right upper abdomen with vomiting for 12 hours.Abdominal ultrasound and computed tomography (CT) scan showed gallbladder enlargement and signs of acute cholecystitis in emergency examination, and there were no signs of cholecystolithiasis. Considering that the patient was a young male and the patients prefer conservative treatment, symptomatic treatment was given. However, there was no obvious effect after 1 day of medical treatment, but severe abdominal pain in the upper right quadrant continues to progress. Finally, the patient underwent laparoscopic cholecystectomy, and the gallbladder was found to be enlarged with ischemic necrosis, which was caused by gallbladder torsion. The patient recovered 2 days after surgery and was discharged without complications.Conclusions: Although the clinical manifestation is similar to that of typical acute calculous cholecystitis, gallbladder torsion can be diagnosed early through some special signs on imaging examination, such as distorted cystic duct signs ("beak and whirl" sign), gallbladder dilatation with gallbladder fossa effusion, and gallbladder in the horizontal position. These signs can help primary surgical treatment and prevent fatal complications such as gallbladder gangrene, perforation, and biliary peritonitis. Therefore, for inexperienced doctors, careful imaging features are required for the correct diagnosis of rare gallbladder torsion.

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Single‐incision laparoscopic cholecystectomy for gallbladder torsion: A case report and literature review

Cited by 8 publications

References 7 publications

A comparative analysis of gallbladder torsion and acute gallbladder disease without torsion: a single-center retrospective case series study

A comparative analysis of gallbladder torsion and acute gallbladder disease without torsion: a single-center retrospective case series study

Case report: Rare floating gallbladder torsion in a child

Acute abdominal disease associated with gallbladder torsion recovered after cholecystectomy: a rare case report and literature review

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