A Case of Gallstones with Complete Situs Inversus Treated by Laparoscopic Cholecystectomy

Abstract

A 66-year-old man was admitted to our hospital for treatment of cholelithiasis. He had been diagnosed with complete situs inversus in childhood. Abdominal ultrasound and contrast-enhanced computed tomography (CT) showed an atrophied gallbladder, gallstones, and complete situs inversus. Laparoscopic cholecystectomy was performed double-handed using four trocars. The operator stood on the right side of the patient, and the trocars were inserted symmetrically as for conventional laparoscopic cholecystectomy. However, the operator's right-hand trocar position was shifted approximately 7 cm to the foot side to maintain the distance from the gallbladder. Thus, all operative procedures, including dissection at Calot's triangle, could be easily performed with the right hand. The operation lasted 44 minutes without complications, and the patient was discharged on postoperative day 4. This case demonstrated that our modified trocar position can be useful in laparoscopic cholecystectomy with complete situs inversus.