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Surgical approach to a left-sided gallbladder
  1. Ryan Pereira1,2,
  2. Marlon Perera1,
  3. Matthew Roberts1 and
  4. John Avramovic2
  1. 1 Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
  2. 2 Mater Hospital Pimlico, Aitkenvale, Queensland, Australia
  1. Correspondence to Dr Marlon Perera, marlonlperera{at}


Biliary colic is a pain in the right upper quadrant or epigastrium thought to be caused by functional gallbladder spasm from a temporary obstructing stone in the gallbladder neck, cystic duct or common bile duct. A 56-year-old man presented with frequent episodes of typical biliary colic. At initial laparoscopy, the gallbladder was absent from its anatomic location. Further inspection revealed a left-sided gallbladder (LSGB), suspended from liver segment 3. Preoperative ultrasound, the most common imaging modality for symptomatic gallstones, has a low positive predictive value for detecting LSGB (2.7%). Laparoscopic cholecystectomy (LC) was delayed to attain additional imaging. A magnetic resonance cholangiopancreatography demonstrated the gallbladder left of the falciform ligament with the cystic duct entering the common hepatic duct from the left. The patient underwent an elective LC 8 weeks later. The critical view of safety is paramount to safe surgical dissection and could be safely achieved for LSGB.

  • biliary intervention
  • pancreas and biliary tract
  • general surgery
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  • Contributors RP wrote the original draft of the manuscript. Figure 3 is original figure created by RP. RP and MP performed the literature search. MR and JA provided the colour images and edited the manuscript. All authors reviewed, edited and approved the final version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.

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