A Case of Laparoscopic Cholecystectomy for Acute Cholecystitis associated with the Left-Sided Gallbladder and an Aberrant Hepatic Duct

Naoki Matsumoto, Hiroshi Hasegawa, Takashi Shiroko, Eiji Sakamoto, Shunichiro Komatsu, Yasuhiro Kurumiya, Shinji Norimizu, Tomotake Tabata, Seiji Natsume and Taro Aoba

Department of Surgery, Nagoya Daini Red Cross Hospital

A 60 year-old man admitted for fever and epigastralgia was found in computed tomography to have a swollen gall bladder with a thickened wall located to the left of the umbilical portion and diagnosed as acute cholecystitis of the left-sided gall bladder. Direct cholangiography showed the aberrant right hepatic duct, draining into the cystic duct. After reducing inflammation by perctaneous transhepatic gall bladder drainage (PTGBD), we conducted laparoscopic cholecystectomy. The gall bladder wall was stiff and the gall bladder fundus was located to the left of the ligamentum teres. We dissected the liver bed, endeavoring to avoid umbilical injury. We stapled and closed the neck of the gall bladder, without approaching the cystic duct to avoid damaging the aberrant hepatic duct. The man was discharged on post operative day 6. We found no record of such a case in the Japanese literature.

Key words
aberrant hepatic duct, left-sided gallbladder, subtotal cholecystectomy

Reprint requests
Naoki Matsumoto Division of Surgery, Nagoya Daini Red Cross Hospital
2-9 Myoken-cho, Showa-ku, Nagoya, 466-8650 JAPAN

Accepted
February 20, 2008

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