Publication: Cholecystectomy in Situs Inversus Totalis
Date
2025
Article Type
Case Report
Journal Title
Journal ISSN
3059-9547
Volume Title
Pages
Pages: 112 - 114
Publisher
Public Health Concern Trust-Nepal (phect-NEPAL)
Abstract
Abstract:
Situs inversus totalis (SIT) involves a systemic reversal of visceral organs, complicating both clinical diagnosis and operative strategy. While laparoscopic cholecystectomy is the gold standard for cholelithiasis, its application is challenged by this rare anatomical anomaly. In cases of SIT with dextrocardia, atypical presentations and mirrored anatomy can obscure diagnosis and increase operative complexity. A 39-year-old man was diagnosed with dextrocardia via chest X-ray. Ultrasonography and computed tomography confirmed SIT, cholecystitis, and cholelithiasis. We attempted laparoscopic cholecystectomy using a modified technique involving left-handed maneuvers and adjusted port positions. However, due to dense adhesions between the gallbladder, omentum, and transverse colon, a Critical View of Safety (CVS) could not be achieved. The procedure was converted to an open cholecystectomy via a left subcostal incision. The operation went well, and our patient recovered satisfactorily.
Description
Subas Thapa Magar
Department of General Surgery, Kathmandu Model Hospital, Kathmandu, Nepal
Uday Koirala
Department of General Surgery, Kathmandu Model Hospital, Kathmandu, Nepal
Bijendra Dhoj Joshi
Department of General Surgery, Kathmandu Model Hospital, Kathmandu, Nepal
Sudip Shakya
Department of General Surgery, Kathmandu Model Hospital, Kathmandu, Nepal
Pushpa Lal Bhadel
Department of General Surgery, Kathmandu Model Hospital, Kathmandu, Nepal
Keywords
cholecystectomy, gallbladder, laparoscopic, situs inversus totalis
Identifier
https://doi.org/10.63455/88tetf89