Left-Sided Gallbladder Without Situs Viscerum Inversus: A Rare Intraoperative Finding During Laparoscopic Cholecystectomy

Abstract

Left-sided gallbladder without situs viscerum inversus (LSG-woSVI) is a rare congenital anomaly often discovered incidentally during surgery, as it frequently eludes preoperative imaging. We report a case of a 51-year-old male who presented with intermittent right upper abdominal pain for six months. Clinical examination and liver function tests were unremarkable. Ultrasound imaging
detected cholelithiasis but failed to identify any positional anomalies. During routine laparoscopic cholecystectomy, the gallbladder was unexpectedly found on the left side of the round ligament, confirming a diagnosis of true LSG-woSVI. No features of situs inversus were noted. An additional left subcostal port was placed to facilitate retraction and dissection. Careful dissection revealed the cystic duct joining the common hepatic duct on the right side, and the cystic artery running anterior to the duct from right to left. Retrograde cholecystectomy was completed without complications. Histopathology confirmed chronic cholecystitis. The patient recovered uneventfully and was discharged on the second postoperative day. This case highlights the importance of intraoperative vigilance and awareness of anatomical variants in laparoscopic surgery, especially when preoperative imaging fails to detect anomalies. Prompt
recognition and appropriate modification of surgical technique are crucial to avoid bile duct injury and ensure safe outcomes.