Fluorescence cholangiography during laparoscopic cholecystectomy in a patient with situs inversus totalis: a case report and literature review

BMC Surgery

Case Report

Narongsak Rungsakulkij¹  Pongsatorn Tangtawee¹ 

[1] Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 10400, Bangkok, Thailand;

关键词: Situs inversus;    Situs inversus totalis;    Laparoscopic cholecystectomy;    Fluorescence cholangiography;    Cholelithiasis;   

DOI  :  10.1186/s12893-017-0242-x

 received in 2017-02-08, accepted in 2017-04-11,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundSitus inversus totalis is a rare autosomal disorder in which the patient’s affected visceral organs are a perfect mirror image of their normal positions. Surgery in these patients is technically challenging. Minimally invasive surgery such as laparoscopic cholecystectomy is the standard treatment for symptomatic cholelithiasis, but it can be difficult to perform. Laparoscopic cholecystectomy in patients with situs inversus totalis may be even more technically challenging. Fluorescence cholangiography is a new innovation in the field of navigation surgery. This procedure is safe and easy to perform, its findings are easy to interpret, and it does not require a learning curve or radiographs. It can be used in real time during surgery to identify extrahepatic biliary structures.Case presentationWe herein report a case of situs inversus totalis in a Thai patient with a history of biliary pancreatitis. He underwent laparoscopic cholecystectomy with intraoperative fluorescence cholangiography. The operation was successfully completed without complications. To the best of our knowledge, this is the first case report of the use of fluorescence cholangiography during laparoscopic cholecystectomy in a patient with situs inversus.ConclusionFluorescence cholangiographyis a new navigational surgical technique with which to identify extrahepatic biliary structures. It can be used as an adjunct technique during laparoscopic cholecystectomy to avoid biliary tract injury in difficult cases.

【 授权许可】

CC BY   
© The Author(s). 2017