1994 Volume 36 Issue 11 Pages 2230-2234_1
A 42-year-old man with sudden onset of right epigastric pain was admitted to our hospital. Preoperative ultrasonography, ERCP and enhanced computed tomography showed some interesting findings as follows : the tail of the gallbladder was situated on the left side of the round ligament, the neck of it curved and cystic duct met left side of the common bile duct. Echogenic shadowing lesiones were detected and the fundus were thick. No abnormal formation of the portal vein was seen on ultrasonography. Under general anaesthesia, umbilical skin incision was made by closed laparoscopic method and four trocars (three 10mm and one 5mm) were inserted as usual manner. Another trocar was inserted from left side to tug the gallbladder to the left side. The neck of the gallbladder closely adhered to the common bile duct and cystic artery was a branch of the left hepatic artery. Left sided gallbladder without situs inversus totalis is a rare condition. We concluded that laparoscopic cholecystectomy could be applied to this case and the trocar inserted from left side was necessary for this operation.
