Left-Sided Gallbladder: Tips and Tricks to Safe Cholecystectomy

Left-sided gallbladder (LSGB) is a rare anatomical variation where the gallbladder is to the left of the falciform ligament and ligamentum teres. Most commonly, it is discovered as an incidental finding at the time of operation (typically for cholecystectomy). We describe a case of left-sided gallbladder in a 71-year-old female. The patient presented with complaints of pain in the right upper quadrant and epigastric area, which had persisted for two months, accompanied by intermittent biliary colic over the previous five years. An ultrasound demonstrated a single 39 mm gallstone. She underwent an elective laparoscopic cholecystectomy, during which an incidental discovery of an LSGB occurred. Patients with LSGB have a relatively high risk of complications when proceeding with operative interventions, likely secondary to concurrent biliary and arterial anatomical variants. Images of the anatomy of LSGB and possible adaptations to the usual laparoscopic cholecystectomy techniques necessary to perform a safe operation are discussed, including division of the falciform ligament and altered port placements. LSGB is a rare anatomical variation that increases surgical risk at the time of cholecystectomy. Understanding this variation in anatomy is critical to undertaking safe operative interventions in these patients.