Our Summary

This paper discusses a case where an 80-year-old woman had a twisted gallbladder, a condition also known as gallbladder torsion (GT). She had sudden pain and a mass that could be felt in the upper right part of her stomach. A CT scan showed that her gallbladder was swollen and not in the right place, and the ducts that connect to the liver were distorted, which are signs of GT.

The doctors treated her by doing a type of surgery called a single-incision laparoscopic cholecystectomy. This is a minimally invasive surgery where they make a small cut and insert a camera and tools to remove the gallbladder. During the surgery, they found that her gallbladder had twisted 180 degrees in the counterclockwise direction. After the surgery, she recovered without any problems and was able to leave the hospital on the seventh day.

The first time this type of surgery was used for GT was in 1994, and since then, 28 cases have been treated this way, including this woman’s case. The authors suggest that this could be the standard way to treat GT in the future, because it seems to work well and is less invasive than other surgical options. They also think that the single-incision technique may be especially good for patients with GT because of the particular way the gallbladder is twisted.

FAQs

  1. What is gallbladder torsion and how is it diagnosed?
  2. What is the process of single-incision laparoscopic cholecystectomy for gallbladder torsion?
  3. How common is the use of laparoscopic cholecystectomy for treating gallbladder torsion?

Doctor’s Tip

A helpful tip a doctor might tell a patient about laparoscopic cholecystectomy is to follow all pre-operative instructions provided by the medical team, including fasting guidelines and medication management. Additionally, after the procedure, it is important to follow post-operative care instructions carefully, including proper wound care, pain management, and activity restrictions to ensure a smooth recovery. It is also important to attend all follow-up appointments with the medical team to monitor progress and address any concerns.

Suitable For

Patients who are typically recommended for laparoscopic cholecystectomy include those with symptomatic gallbladder disease, such as cholecystitis, gallstones, or gallbladder polyps. Other indications for the procedure may include patients with biliary colic, pancreatitis, or choledocholithiasis. In the case of gallbladder torsion, laparoscopic cholecystectomy may be recommended if the patient is stable and the torsion can be safely addressed through minimally invasive surgery. This case study highlights the successful use of single-incision laparoscopic cholecystectomy for a patient with gallbladder torsion, demonstrating that this approach may be a viable option for certain patients with this condition.

Timeline

Before laparoscopic cholecystectomy:

  • Patient presents with sudden pain and a palpable mass in the right upper quadrant
  • Contrast-enhanced CT reveals ischemic changes, swollen gallbladder, V-shaped distortion of extrahepatic ducts, and abnormal anatomical position
  • Clinical findings indicate gallbladder torsion

After laparoscopic cholecystectomy:

  • Single-incision laparoscopic cholecystectomy is performed
  • Intraoperatively, floating gallbladder is found twisted counterclockwise by 180° around the cystic duct
  • Patient has an uneventful postoperative course
  • Patient is discharged on postoperative day 7

Overall, laparoscopic cholecystectomy for gallbladder torsion may be a standard treatment, and single-incision laparoscopic cholecystectomy could be a good surgical option for patients with this condition due to its anatomical characteristics.

What to Ask Your Doctor

  1. What is laparoscopic cholecystectomy and how is it different from traditional open surgery?
  2. What are the risks and potential complications of laparoscopic cholecystectomy?
  3. How long will the surgery take and how long is the recovery time?
  4. Will I need to stay overnight in the hospital after the surgery?
  5. How soon after the surgery can I resume my normal activities?
  6. Will I need to make any changes to my diet or lifestyle after the surgery?
  7. Are there any long-term effects or risks associated with having my gallbladder removed?
  8. What should I do if I experience any unusual symptoms or complications after the surgery?
  9. How many laparoscopic cholecystectomies have you performed and what is your success rate?
  10. Are there any alternative treatment options to consider for my condition?

Reference

Authors: Matsubara K, Urushihara T, Oshita A, Itamoto T. Journal: Asian J Endosc Surg. 2018 May;11(2):165-168. doi: 10.1111/ases.12435. Epub 2017 Oct 19. PMID: 29052346