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Case Reports
. 2005 Sep 7;11(33):5232-4.
doi: 10.3748/wjg.v11.i33.5232.

Laparoscopic cholecystectomy in situs inversus totalis with "inferior" cystic artery: a case report

Sumihiro Kamitani  1 , Yosihiro Tsutamoto, Kazuyoshi Hanasawa, Tohru Tani
Affiliations
Case Reports

Laparoscopic cholecystectomy in situs inversus totalis with "inferior" cystic artery: a case report

Sumihiro Kamitani et al. World J Gastroenterol. .

Abstract

A 76-year-old man with known situs inversus totalis presented with left-sided discomfort. Abdominal ultrasonography and CT scan confirmed the diagnosis of a gallstone, as well as, situs inversus; the liver and gallbladder on the left side and the spleen on the right. The biliary system was thought to be left-right reversal, mirror image in the view of drip infusion cholangiogram and MRI. Laparoscopic cholecystectomy was safely performed, despite of unexpected aberrant cystic artery running inferior to cystic duct of situs inversus. Laparoscopic surgeon should be careful for view of reversed relationships and also existence of other anomalies.

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Figures

Figure 1
Figure 1
Reversed cholangiopancreatograms. A: ERCP; B: 3D-DIC CT; C: MRCP.
Figure 2
Figure 2
Arrangement around the operating table and positions of the trocars.
Figure 3
Figure 3
Laparoscopic view during cholecystectomy. A: Gallbladder was placed on the left side and hepatic round ligament on the right; B: the fundus of gallbladder was grasped and tracted; C: the cord was revealed lying inferior to the cystic duct; D: the surroundings of the cystic duct were dissected after the cord was tracted; E: the cystic duct was cut after the clip ligature; F: the cord lead only to the gallbladder.
See this image and copyright information in PMC

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