Laparoscopic Cholecystectomy in a Right Hepatic Lobe Hypoplasia Patient with Cholecystolithiasis. Report of A Case

Kyoei Morozumi, Hiroshi Miyazaki, Shin Narai, Akio Furukawa, Yuichi Okamoto and Tomoki Nakamura

Department of Surgery, Tokyo Fussa Hospital

A female patient, aged 56 years, visited our clinic, complaining of epigastric pain. Abdominal computed tomography and three-dimensional spiral CT cholangiography revealed hypoplasia of the right hepatic lobe and absence of the caudate lobe. The lateral segment of the left hepatic lobe showed compensatory hypertrophy. The gallbladder, located posterior to the medial segment of the left lobe, contained a stone. Laparoscopy also showed hypoplasia of the right lobe and hypertrophy of the lateral segment of the left hepatic lobe, but could not point out the location of the gallbladder in the supine position. The patient, positioned on a surgical bed of which the head end was elevated and the left side was steeply lowered, underwent laparoscopic cholecystectomy using five trocars. Hypoplasia of the right hepatic lobe is a relatively rare morphological abnormality, and only 41 cases have been noted in Japan since 1985. This hypoplasia often results in complications including displacement of gallbladder, biliary tract disease, and particulary cholelithiasis. Cases with complications such as absence of the right section of the diaphragm and presinusoidal portal hypertension have been reported overseas. We believe that this is the worldwide first report that laparoscopic cholecystectomy has successfully performed in a gallstone patient with hypoplasia of the right hepatic lobe.

Key words
right liver lobe hypoplasia, laparoscopic cholecystectomy, suprahepatic gallbladder

Reprint requests
Kyoei Morozumi Department of Surgery, Tokyo Fussa Hospital 1-6-1 Kamidaira, Fussa, 197-8511 JAPAN

Accepted
May 23, 2000

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