A Case of Laparoscopic Cholecystectomy for Acute Cholecystitis in the Umbilical Region of the Right Portal Vein

Abstract

The patient was a man in his 30s who visited a neighborhood hospital complaining of epigastralgia and was referred to our department. Abdominal ultrasonography (US) revealed an enlarged gallbladder (GB). Computed tomography (CT)/magnetic resonance cholangiopancreatography (MRCP) revealed that the fundus of the GB was located in the left hepatic lobe, and that the fatty tissue density around the GB was increased. The right portal vein branches diverged from the umbilical portion, and we made the diagnosis of acute cholecystitis with the right umbilical portion. Laparoscopic cholecystectomy (LC) was successfully performed by inserting the epigastric port into the left side of the round ligament and performing fundic dissection of the GB. Even in a case of acute cholecystitis with the right umbilical portion, it is important to determine the location of the biliary tree and biliary tract on preoperative imaging, although it may prove difficult in cases with severe inflammation, and a bailout surgery policy should be kept in mind.