title: Laparoscopic cholecystectomy and common bile duct exploration for cholecystocholedocholithiasis with a left-sided gallbladder: report of a case.
abstract: A 75-year old woman was admitted to our hospital with right upper quadrant pain, vomiting, and jaundice. Laboratory findings showed elevated total bilirubin, alkaline phosphatase, gamma-glutamyl transpeptidase, and C-reactive protein levels. Abdominal ultrasonography (US) and drip infusion cholangiographic computed tomography (DIC-CT) showed not only cholecystocholedocholithiasis, but a gallbladder located left of the round ligament and close to the lateral segments of the liver. We performed laparoscopic cholecystectomy (LC) with choledocholithotomy for suspected cholecystocholedocholithiasis with a left-sided gallbladder. Routine ports were inserted in the American configuration for LC. The gallbladder was normogradely separated from the gallbladder fossa, and the fundus of the gallbladder was lifted ventrally and toward to the patient's right shoulder. These procedures provided the usual view for laparoscopic choledochotomy. The patient recovered uneventfully and was discharged on postoperative day 10. To our knowledge, this is the first report of laparoscopic common bile exploration in a patient with a left-sided gallbladder.
authors.affiliation: Department of Surgery, Tohoku Rosai Hospital, 4-3-21 Dainohara, Aoba-ku, Sendai, 981-8563, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Matsumura
authors.forename: Hiromi
authors.initials: H
authors.lastname: Tokumura
authors.forename: Akihiro
authors.initials: A
authors.lastname: Yasumoto
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Sasaki
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Yamasaki
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Musya
authors.forename: Shoji
authors.initials: S
authors.lastname: Fukuyama
authors.forename: Kenichi
authors.initials: K
authors.lastname: Takahashi
authors.forename: Takashi
authors.initials: T
authors.lastname: Toshima
authors.forename: Yuji
authors.initials: Y
authors.lastname: Funayama
mesh_terms: D000368:Aged; D017081:Cholecystectomy, Laparoscopic; D041761:Cholecystolithiasis / Q000000981:diagnostic imaging / Q000601:surgery*; D042883:Choledocholithiasis / Q000000981:diagnostic imaging / Q000601:surgery*; D003937:Diagnosis, Differential; D005260:Female; D005704:Gallbladder / Q000002:abnormalities* / Q000601:surgery; D006801:Humans; D008111:Liver Function Tests; D011859:Radiography; D014463:Ultrasonography