Aberrant Presentation of the Gallbladder During Laparoscopic Cholecystectomy

BACKGROUND: Aberrant gallbladder transposed to the left side is a rare congenital anomaly that has been seen in as many as 0.7% of the population. These gallbladders are situated under the left lobe of the liver between Segment III and IV and to the left of the falciform ligament. Many preoperative studies fail to identify the anomaly, causing confusion to the surgeon during laparoscopic resection. Selective use of intraoperative cholangiography and meticulous dissection can aid in safe resection. METHODS: A 61-year-old female was admitted with ultra-sound confirmation of cholecystitis and subsequently taken to the operating room for a laparoscopic cholecystectomy. RESULTS: Evaluation of the gallbladder under laparoscopic view revealed an inflamed left aberrant gallbladder. An intraoperative cholangiogram was obtained to delineate the biliary anatomy that showed the cystic duct entering the common hepatic duct on the right side. CONCLUSION: A left aberrant gallbladder is a rare presentation that requires awareness of biliary anatomy and selective use of intraoperative cholangiography to aid in the safe laparoscopic resection of the gallbladder.