左側胆嚢症に対し腹腔鏡下胆嚢摘出術を施行した3例の検討

We experienced a series of 370 cases of laparoscopic cholecystectomy (Lap-C) between January 1992 and December 2001, of which three cases (0.8%) were left-sided gallbladder. When we perform Lap-C to left-sided gallbladder, we have to recognize the anatomical specificity of this disease, and to avoid the complication like injury of arteries or bile ducts. In this study we performed Lap-C to three cases of left-sided gallbladder. In all cases, the gallbladder bed were located at the left side of the hepatic round ligament, and the cystic duct were connected to normal position of the common bile duct. And in all cases, there were no anomalies of the intrahepatic portal vein. One of these cases, falling of the hepatic round ligament was seen, then we tried to insert a trocar at the left side of the ligament and to pick up it by silk. Then we could get a good view and easily performed Lap-C. In all cases we could underwent Lap-C without complication. We considered that Lap-C was to be a standard operation method for malformation cases like a left-sided gallbladder.