Dr Narotam Dewan presents rare case of Laparoscopic Cholecystectomy of Left Sided Gall bladder

Ludhiana, September 23, 2014: Dr Narotam Dewan, Consultant Surgeon, Dewan Hospital & Advanced Laparoscopic Surgery Centre was invited to Chair surgical sessions and as National Faculty to “7th National Conference of Society of Endoscopic and Laparoscopic Surgeons of India, International Workshop cum CME” held at Bhubeshwar from September 18-21.
Dr Narotam Dewan presented there a video research paper on “ Laparoscopic Cholecystectomy in Ectopic Left Sided Gall Bladder”. This presentation was based on a rare surgery of Left sided ectopic gall bladder done by Dr Narotam Dewan at Dewan Hospital & Advanced Laparoscopic Surgery Centre. This is a  rare congenital anomaly defined as a gall bladder attached to the lower surface of the left lateral segment of the liver. It is found only in about 1 in thousand cases. Normally the gall bladder is present on the right side.
 Left sided gall bladder is of two types 1. Associated with a condition called situs inversus in which all the parts of the body are on the other side e.g. heart on the right and  liver & gall bladder on the left. In situs inversus the diagnosis of  left sided gall bladder can be made before surgery. 2. When it is not associated with general situs inversus. The gall bladder fails to develop on the right side and rather develops on the left side. In most of these cases this diagnosis is missed on ultrasound throughout the world. So, it presents as a surprise to the surgeon at the time of surgery. This left sided gall bladder is often associated with other abnormalities of billary system or blood vessels of the area. The reflexes of the surgeon are tuned to operate gall bladder on the right side and to save the important structures while the gall bladder is mobilized and removed.
Left sided gall bladder with associated anatomical abnormalities throws a challenge and demands surgical prudence, quick modification of technique, caution, careful dissection, delineation of all important anatomical landmarks and avoiding the division of structures until a clear picture is obtained.
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