Bai-Yong Shen1, Jean-Marc Regimbeau, Hong-Wei Li. 1. Department of Surgery, Ruijin Hospital, Shanghai Second Medical University, Shanghai 200025, China. shenbaiyong@medmail.com.cn
Abstract
BACKGROUND: Despite its rare incidence, few cases of left-side gallbladder have been already published. METHODS: We reported herein the case of a 29-year-old man with a left liver tumor in whom left lateral bisegmentectomy was mandatory. It represents the first description of a sinistroposition of both gallbladder and common bile duct. RESULTS: Surgical exploration revealed a left-side gallbladder, located under the left lobe of the liver. During hepatic parenchyma dissection at the left side of the round ligament and the Rex recessus, the common bile duct was injured. Complete separation of hepatic pedicle structures showed that the upper biliary convergence passed on the left side of the Rex recessus before reaching the hepatoduodenal ligament. CONCLUSION: Only careful dissection of the hepatoduodenal ligament up to Rex recessus level prior to liver parenchyma resection could avoid biliary tract injury during left lobectomy.
BACKGROUND: Despite its rare incidence, few cases of left-side gallbladder have been already published. METHODS: We reported herein the case of a 29-year-old man with a left liver tumor in whom left lateral bisegmentectomy was mandatory. It represents the first description of a sinistroposition of both gallbladder and common bile duct. RESULTS: Surgical exploration revealed a left-side gallbladder, located under the left lobe of the liver. During hepatic parenchyma dissection at the left side of the round ligament and the Rex recessus, the common bile duct was injured. Complete separation of hepatic pedicle structures showed that the upper biliary convergence passed on the left side of the Rex recessus before reaching the hepatoduodenal ligament. CONCLUSION: Only careful dissection of the hepatoduodenal ligament up to Rex recessus level prior to liver parenchyma resection could avoid biliary tract injury during left lobectomy.