Left-sided gallbladder

¹Service Chirurgie A, Centre Hospitalo-Universitaire Ibn Sina, Université Mohammed V de Rabat, Rabat, Maroc, ²Faculté de Médecine et de Pharmacie, Université Mohammed V de Rabat, Rabat, Maroc, ³Service Viscéral II, Hôpital d´Instruction Militaire Mohamed V, Faculté de Médecine et de Pharmacie de Rabat, Rabat, Maroc

^&Corresponding author
Karim Bellarabi, Service Chirurgie A, Centre Hospitalo-Universitaire Ibn Sina, Université Mohammed V de Rabat, Rabat, Maroc

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Aberrant gallbladder beneath the left liver is a rare congenital anomaly that is found in 0.1-0.7 percent of the population. A 24-year-old female complaining about pain in her right upper abdomen with nausea and flatulent dyspepsia. There was no history of fever, jaundice and liver function tests were normal. The ultrasound of the liver showed a simple lithiasic gallbladder without precising its location, although its insertion was evident to the left of the falciform ligament (A). A laparoscopic cholecystectomy was planned and peroperatively we found an abnormal location of the gallbladder under the left side of the liver (B). An anterograde cholecystectomy was performed without resorting to intraoperative cholangiography. The postoperative consequences were normal. Left-sided gallbladders have been associated with anomalies of the portal vein, the biliary tract and atrophy of segment IV. Many studies suggest performing cholecystectomy normogradely in order to obtain an optimal view of Calot´s triangle. In addition, he found that a subxiphoid port to the left of the round ligament facilitated manipulation of the gallbladder, allowing to relocate the gallbladder to the right of the common bile duct. On the other hand, others suggested the use of the antegrade approach in order to well visualize the structures.

Figure 1: A) ultrasound of the left gallbladder: B) laparoscopic picture of the gallbladder under the left liver