- 作者：Russell W. Strong ; M.D. ; russell_strong@health.qld.gov.au ; Jonathan Fawcett ; M.D. ; Michael Hatzifotis ; M.D. ; Peter Hodgkinson ; M.D. ; Stephen Lynch ; M.D. ; Thomas O'Rourke ; M.D. ; Kellee Slater ; M.D. ; Shinn Yeung ; M.D.
- 关键词：Left-sided gallbladder ; Preoperative diagnosis ; Bile duct injury ; Intrahepatic portal ; Venous and biliary systems ; Hepatic resection
- 刊名：The American Journal of Surgery
- 出版年：2013
- 出版时间：July, 2013
- 年：2013
- 卷：206
- 期：1
- 页码：59-63
- 全文大小：810 K
Background
A left-sided gallbladder in a normally positioned liver is considered to be a very uncommon anomaly. Laparoscopic cholecystectomy can be performed safely, but bile duct injury is not unusual. It is associated with anomalous intrahepatic portal and biliary systems which impacts any form of partial hepatectomy.Methods
We performed a retrospective review of patients with left-sided gallbladder who were managed by the hepatobiliary surgeons at our institution since 1996.
Results
Nineteen patients with left-sided gallbladder underwent a hepatobiliary procedure. Of the 13 patients with gallstones, only 1 was diagnosed before cholecystectomy. Nine operations were completed laparoscopically, whereas 4 required an open procedure. Two patients were referred with bile duct injuries. There was 1 liver resection for a colorectal metastasis. Left-sided gallbladders in 3?deceased organ donors resulted in major implications in the performance of liver transplantation.
Conclusions
Left-sided gallbladders are probably more common than generally believed but are rarely diagnosed before cholecystectomy. Associated bile duct injury appears to be not infrequent. Because of the aberrant vasculobiliary anatomy, any form of liver resection requires careful planning.