An unusual case: Atypical localization of the gallbladder

Year 2025, Volume: 39 Issue: 4, 339 - 344, 30.10.2025

Servet Tali

https://doi.org/10.18614/dehm.1813866

Abstract

We present a in a sixty-eight-year-old male patient with a congenital abnormality scheduled for metabolic surgery. The anomaly was characterized by the gallbladder’s unusual placement in the left lobe of the liver. Preoperative evaluations revealed no gallbladder pathology, but during metabolic surgery, we observed that the gallbladder was localized to the left lobe of the liver and adhered to the surrounding tissues. The case was considered as "acalculous cholecystitis," and the patient underwent cholecystectomy. The procedure progressed smoothly, and was successfully completed without complications, following the criteria for safe cholecystectomy.
The biliary system is an area where anatomical variations are quite common; therefore, surgeons performing biliary surgery must have a thorough understanding of these variations. In order to avoid unintended injuries, it is beneficial to take certain technical precautions. When necessary, trocar insertion sites may be modified, and anterograde dissection can be performed. All anatomical structures should be clearly identified before clipping, and the cystic duct should be clipped as close to the infundibulum as possible.

Keywords

Congenital biliary anomaly , cholecystectomy , gallbladder variations

References

• 1. Van De Graaff K. Human Anatomy. 6th ed. New York: McGraw-Hill; 2001.
• 2. Catalano OA, Sahani DV, Kalva SP, Cushing MS, Hahn PF, Brown JJ, et al. MR imaging of the gallbladder: a pictorial essay. Radiographics. 2008;28(1):135–55; quiz 324.
• 3. Putman CE. Textbook of Diagnostic Imaging. Philadelphia: W.B. Saunders; 1994. p.908–59.
• 4. Köksal HM, Celayir MF, Vartanesyan ZÇ, Baykan A. Left-located gallbladder: case report. Turk J Surg. 2010;26(4).
• 5. Alyanak A, Gülen M, Ege B. Rare left lobar placing gall bladder operation: a case report. J Health Sci Yuksek Ihtisas Univ. 2022;3(2).
• 6. Abongwa HK, De Simone B, Alberici L. Implications of left-sided gallbladder in the emergency setting: retrospective review and top tips for safe laparoscopic cholecystectomy. Surg Laparosc Endosc Percutan Tech. 2017;27(4).
• 7. Moo-Young TA, Picus DD, Teefey S, Strasberg SM. Common bile duct injury following laparoscopic cholecystectomy in the setting of sinistroposition of the gallbladder and biliary confluence: a case report. J Gastrointest Surg. 2010.
• 8. Nagendram S, Lynes K, Hamade A. A case report on a left-sided gallbladder: a rare finding during cholecystectomy. Int J Surg Case Rep. 2017;14(1).
• 9. Chrungoo RK, Kachroo SL, Sharma AK, Khan AB, Nadim AS. Left-sided gallbladder: report of two cases. J Minim Access Surg. 2007;3(3):108–10.
• 10. Savier E, Taboury J, Lucidarme O, Kitajima K, Cadi M, Vaillant JC, et al. Fusion of the planes of the liver: an anatomic entity merging the midplane and the left intersectional plane. J Am Coll Surg. 2005;200(5):711–9.
• 11. Lucidarme O, Taboury J, Savier E, Cadi M, Hannoun L, Grenier PA. Fusion of the midplane with the left intersectional plane: a liver anatomical variation revisited with multidetector-row CT. Eur Radiol. 2006;16(8):1699–708.
• 12. Hsu SL, Chen TY, Huang TL, Sun CK, Concejero AM, Tsang LLC, Cheng YF. Left-sided gallbladder: its clinical significance and imaging presentations. World J Gastroenterol. 2007;13(47):6404–9.
• 13. Kubo S, Lee S, Yamamoto T, Edagawa A, Kinoshita H. Left-sided gallbladder associated with anomalous branching of the portal vein detected by sonography. J Osaka City Med Cent. 2000;46(2):95–8.
• 14. Colovic R, Colovic N, Barisic G, Atkinson HDE, Krivokapic Z. Left-sided gallbladder associated with congenital liver cyst. HPB (Oxford). 2006;8(2):157–8.
• 15. Bender EA, Springhetti S, Shemisa K, Wittenauer J. Left-sided gallbladder (sinistroposition) with duplication of the common bile duct. [Journal name incomplete].