Laparoscopic cholecystectomy for chronic stone cholecystitis in a patient with situs inversus totalis managed at the Delfina Torres De Concha Hospital in Esmeraldas; case report
DOI:
https://doi.org/10.56294/saludcyt2024.613Keywords:
situs inversus, cholecystitis, cholelithiasis, laparoscopic cholecystectomyAbstract
Situs Inversus Totalis (SIT) is when all the organs of the body are inverted towards the opposite side. Its incidence varies between 1 in 5.000 and 1 in 20.000 people, and it is due to an autosomal recessive gene. This disorder is characterized by the mirror arrangement of the thoracic and abdominal viscera, and can lead to cardiac, intestinal and vascular complications. Although laparoscopic cholecystectomy is the standard treatment for cholelithiasis, it can present technical challenges in cases of situs inversus, especially for right-handed surgeons, and it is preferable to be performed by a left-handed surgeon, although this is not strictly essential.
Although there is no evidence of a higher incidence of cholelithiasis in patients with situs inversus totalis, more variations and abnormalities are expected in these patients. This report presents the case of a female patient with SIT who underwent laparoscopic cholecystectomy, demonstrating that the procedure can be performed safely with minimal adaptations, such as in this case the variant of using an 11 mm trocar in the third port for the handling of the clipper for skilled surgeons in any health home that has the equipment and trained personnel, given the rarity of this condition, these cases provide valuable information and challenge to the conventional understanding of organ positioning
References
1. Zakko SF, Afdhal NH. Colecistitis litiásica aguda: características clínicas y diagnóstico – UpToDate. 24 de abril de 2024. Disponible en: https://www.uptodate.com/contents/acute-cholecystitis
2. Gallaher JR, Charles A. Colecistitis aguda: una revisión. JAMA. 2022;327(11):965. Disponible en: https://doi.org/10.1001/jama.2022.965
3. Soper NJ, Malladi P. Colecistectomía laparoscópica. UpToDate. 16 de febrero de 2024. Disponible en: https://www.uptodate.com/contents/laparoscopic-cholecystectomy
4. Keus F, Broeders IA, van Laarhoven CJ. Enfermedad de cálculos biliares: aspectos quirúrgicos de la colecistolitiasis sintomática y colecistitis aguda. Best Pract Res Clin Gastroenterol. 2006;20(6):1031-1041. Disponible en: https://doi.org/10.1016/j.bpg.2006.03.001
5. Sinha R, Gurwara AK, Gupta SC. Colecistectomía laparoscópica bajo anestesia espinal: un estudio de 3492 pacientes. J Laparoendosc Adv Surg Tech A. 2009;19(3):323-327. Disponible en: https://doi.org/10.1089/lap.2008.0184
6. Haueter R, Schütz T, Raptis DA, et al. Metanálisis de colecistectomía laparoscópica de puerto único versus colecistectomía laparoscópica convencional comparando la imagen corporal y la estética. Br J Surg. 2017;104(9):1141-1150. Disponible en: https://doi.org/10.1002/bjs.10597
7. Molina GA, Jiménez G, Ayala O A, Di Stefano MT, Suárez FR, Carvajal A, et al. Inside out, and upside down, laparoscopic surgery on Situs Inversus Totalis report of 2 cases on IESS Quito-Sur. Int J Surg Open. 2023;100633. Disponible en: https://doi.org/10.1016/j.ijso.2023.100633
8. Hamad MA, Thabet M, Badawy A, et al. Colecistectomía laparoscópica versus abierta en pacientes con cirrosis hepática: un estudio prospectivo y aleatorizado. J Laparoendosc Adv Surg Tech A. 2010;20(5):405-409. Disponible en: https://doi.org/10.1089/lap.2009.0342
9. Eitler K, Bibok A, Telkes G. Situs inversus totalis: a clinical review. Int J Gen Med. 2022; 15:2437-2449. Disponible en: https://doi.org/10.2147/IJGM.S295444
10. Blegen HM. Surgery in situs inversus. Ann Surg. 1949;129(2):244-259. Disponible en: https://doi.org/10.1097/00000658-194902000-00009
11. Brown KM, Gundara JS, Mittal A. Acute gastrointestinal manifestation of situs inversus abdominus. Hernia. 2017;21(4):649-651. Disponible en: https://doi.org/10.1007/s10029-016-1519-1
12. Agha RA, Franchi T, Sohrabi C, Mathew G, Kerwan A, SCARE Group. The SCARE 2020 guideline: updating consensus surgical case report (SCARE) guidelines. Int J Surg. 2020; 84:226-230. Disponible en: https://doi.org/10.1016/j.ijsu.2020.10.034
13. Moyon CMA, Rojas CL, Moyon CFX, Aguayo WG, Molina GA, Ochoa C, et al. Acute cholecystitis and residual choledocholithiasis in a situs inversus patient, successful laparoscopic approach and ERCP: a case report from Ecuador. Ann Med Surg. 2020; 54:101-105. Disponible en: https://doi.org/10.1016/j.amsu.2020.04.012
14. Paipilla OA, Molina GA, Zavalza JF, Gil M, Montero ML, Fuster R, et al. Looking in a mirror, laparoscopic gastric sleeve in situs inversus patient: a case report. J Surg Case Rep. 2022;7 Disponible en: https://doi.org/10.1093/jscr/rjac341
15. Pahwa HS, Kumar A, Srivastava R. Laparoscopic cholecystectomy in situs inversus: points of technique. BMJ Case Rep. 2012;2012 Disponible en: https://doi.org/10.1136/bcr-2012-006170
Published
Issue
Section
License
Copyright (c) 2024 José Antonio Guerrero Palma , Danny Alberto Mera Aguilar , Wendy Estefanía Chinchín Correa , Estefani Andrea Yugsi Mera , Gary Alexi Machuca Almeida , Geovanna Nataly Jiménez Mejía, Luis Felipe Carrión Guzmán , Daniel Alexander Safadi Tituaña , José Vicente Fonseca Barragán , Juan Carlos Ruilova Blacio (Author)
This work is licensed under a Creative Commons Attribution 4.0 International License.
The article is distributed under the Creative Commons Attribution 4.0 License. Unless otherwise stated, associated published material is distributed under the same licence.
