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Clinical significance of Left-Sided Gallbladder for laparoscopic cholecystectomy and hepatectomy

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Szymoniuk M., Brachet A., Ciejka K., Zielkowska A., Błaszczyk J., Burdan O., Baj J.
Polish Journal of Surgery
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2023
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vol. 96
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issue 1
65-74
EN
Introduction: A left-sided gallbladder (LSG) represents a rare anatomical variation defined by the location of the gallbladder to the left side of the liver falciform and round ligaments, which is often not discovered until surgery. The reported prevalence of this ectopia ranges from 0.2% to 1.1%. Aim: To summarize the knowledge about LSG and possible coexisting anatomical anomalies, and discuss the clinical significance of the LSG when the patient requires cholecystectomy or hepatectomy. Methods: Comprehensive review of existing literature from the years 2012–2022 based on PubMed, Scopus, and Web of Science databases. Results and discussion: Using standard diagnostic procedures, LSG can remain undetected and represent an accidental intraoperative finding. The attempts to explain the cause of this anomaly have been different, but the numerous variations described do not allow a clear definition of its origin. Although this debate is still open, it is of considerable importance to know that LSG is frequently associated with alterations of both the portal branches and the intrahepatic biliary tree. The association of these anomalies, therefore, represents an important risk of complications in cases when surgical treatment is necessary. The knowledge of LSG and coexisting anatomical variations of the hepatobiliary system, and finally the introduction of suitable technical modifications can be of considerable help in preventing surgical complications in patients with LSG. Significance: This article summarizes existing knowledge about LSG and coexisting anatomical anomalies, whose occurrence can hamper standard procedures such as laparoscopic cholecystectomy or hepatectomy. These findings can be essential and helpful in treating patients with detected LSG to decrease the risk of surgical complications.
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