Abstract
We report a case of cholecystitis with rare anatomic variant which was presented as a displacement of portal vein, bile duct and hepatic artery in hepatoduodenal ligament and right-side ligamentum teres hepatis. A 63-year-old woman was diagnosed as cholecystitis. Abdominal CT revealed that portal vein, bile duct and hepatic artery in hepatoduodenal ligament was located at the ventral side of duodenum. Portal vein was located most ventrally, bile duct at the dorsal side of portal vein and hepatic artery located further dorsally. The gallbladder was adhered to a medial segment of the liver. Laparoscopic cholecystectomy was performed safely under five ports, including left-side of ligamentum teres hepatis and left-side of umbilicus, and elevating ligamentum teres hepatis. It is possible developmental anomaly that each portal vein, bile duct and hepatic artery was located at the ventral side of duodenum. But it is difficult to explain morphogenesis in which all of three structures were located at the ventral side of duodenum. It is a problem in the future to consider the mechanism of anatomic variant.
