Open AccessColecistitis aguda en vesícula biliar izquierda. Presentación de un caso resuelto en forma segura por vía laparoscópica
Author(s) -
Agustín Virgili,
Carlos Wendichansky,
Rodrigo Maroni
Publication year - 2021
Publication title -
revista argentina de cirugía/revista argentina de cirugía
Language(s) - English
Resource type - Journals
eISSN - 2250-639X
pISSN - 0048-7600
DOI - 10.25132/raac.v113.n1.1490.ei
Subject(s) - medicine , gallbladder , cystic duct , cholangiography , general surgery , dissection (medical) , hilum (anatomy) , cholecystectomy , common bile duct , laparoscopic cholecystectomy , bile duct , abnormality , surgery , radiology , psychiatry
Left-sided gallbladder (LSGB) is a rare bile duct abnormality, usually found during a cholecystectomy. Symptoms usually do not differ from those of a normally positioned gallbladder, making the preoperative diagnosis extremely uncommon. We report the case of an acute cholecystitis in a patient whit LSGB, safely managed with laparoscopic surgery. A 24-year-old male patient was admitted to our institution with clinical and radiological signs of acute cholecystitis. The intraoperative finding of an acute cholecystitis in a LSGB made us modify ports positioning and a cholangiograhy was done by direct puncture of the gallbladder before hilum dissection. After the cystic duct was identified, a transcystic cholangiography was performed which confirmed a complete and clear bile duct anatomy and laparoscopic cholecystectomy was safely completed. The intraoperative finding of a LSGB makes the surgeon change some aspects of the usual technique to perform a safe cholecystectomy as LSGB significantly increases the risk of common bile duct injuries. Meticulous dissection of the gallbladder hilum to achieve a critical view of safety and the systematic use of intraoperative cholangiography are extremely important to perform a safe laparoscopic cholecystectomy.