Longest and left-sided gallbladder

Abstract

As laparoscopic cholecystectomy is one of the most common procedure done worldwide. Although anomalies are rare but are associated with congenital malformations of gallbladder, bile ducts and vascular system. Herein, we present a case of young female presenting with symptoms of pain in right hypochondrium with ultrasonographic diagnosis of cholelithiasis undergone successful laparoscopic cholecystectomy with Intraoperative findings of: 1. The length of the gallbladder was measured to be 25.8 cm. 2. The fundus of the gallbladder was placed to the left of the falciform ligament. The gallbladder then extended to the right of the falciform ligament, reached up to the liver margin before taking a U-turn to lie in the usual gallbladder fossa. Anomalies of gallbladder present an important hurdle in successful laparoscopic cholecystectomy. Most of time not known preoperatively encountered during surgery. Isolated left-sided gallbladders are rare and found in 0.040.3% of cases. When there is question about anatomy of biliary tract intraoperatively one should consider for anomalies. A habit of calm and slow dissection with precautions should be developed. Clearance of the anatomical structures with limited use of electrocautery should be done before proceeding towards ligation or clip applications to structures. A surgeon should be well equipped with knowledge of anomalies of gallbladder and meticulous dissection with good exposure of structures should be done when an anomaly found.