Bonomo Steven R, Veenstra Benjamin R, Komar Thomas M, Richter Harry M
Section of Minimally Invasive Surgery, Division of General Surgery, Department of Surgery, John H. Stroger Jr Hospital of Cook County, Chicago, IL 60612, USA.
Rush University Medical Center, Chicago, IL, USA.
JSLS. 2014 Apr-Jun;18(2):338-41. doi: 10.4293/108680813X13693422518632.
True left-sided gallbladder (sinistroposition) is a rare anatomic anomaly in which the gallbladder is found to the left of the falciform ligament, under the left lobe of the liver. Though uncommon, it is important for the surgeon to recognize this finding because the ductal anatomy is unique and the mechanics of the operation provide a technical challenge. Multiple case reports have documented safe management of sinistroposition encountered during conventional laparoscopic cholecystectomy. We present a case of sinistroposition encountered during a single-incision laparoscopic cholecystectomy. We believe that the single-site laparoscopic technique is not only a safe option but may actually provide certain benefits in approaching this difficult anatomy in the properly selected patient and the experienced single-site surgeon's hands.
真性左侧胆囊(左位胆囊)是一种罕见的解剖学异常,即胆囊位于镰状韧带左侧、肝左叶下方。尽管不常见,但外科医生认识到这一发现很重要,因为其导管解剖结构独特,手术操作力学带来技术挑战。多篇病例报告记录了传统腹腔镜胆囊切除术中遇到的左位胆囊的安全处理。我们报告一例单孔腹腔镜胆囊切除术中遇到的左位胆囊病例。我们认为,对于经过适当选择的患者以及经验丰富的单孔手术医生而言,单孔腹腔镜技术不仅是一种安全的选择,而且在处理这种复杂解剖结构时可能确实具有某些优势。