A case of laparoscopic cholecystectomy for gallbladder stone in a patient with complete visceral inversion and abnormal position of hepatic round ligament

Abstract

A 76-year-old woman was admitted to our hospital with epigastric pain and was diagnosed with gallbladder and common bile duct stones associated with complete visceral inversion (situs inversus) by an abdominal CT examination. After removal of choledocholithiasis endoscopically, laparoscopic cholecystectomy was planned. Preoperative abdominal CT examination showed that the gallbladder was associated with an anatomical malposition. It was attached to the right side of hepatic round ligament. Therefore, in addition to adjusting the port position, dome down method was performed to resect the gallbladder. Situs inversus is a congenital developmental abnormality in which the organs are mirror images of the left and right, and the probability of having comorbid malformations in the digestive system, cardiovascular system, and urinary system, etc. Laparoscopic cholecystectomy in a patient with complete visceral inversion and malposition of gallbladder was safely performed after careful preoperative image evaluation and surgical planning.