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World J Clin Cases. Mar 26, 2023; 11(9): 1939-1950
Published online Mar 26, 2023. doi: 10.12998/wjcc.v11.i9.1939
Laparoscopic common bile duct exploration to treat choledocholithiasis in situs inversus patients: A technical review
Bo-Ya Chiu, Shu-Hung Chuang, Shih-Chang Chuang, Kung-Kai Kuo
Bo-Ya Chiu, School of Post-baccalaureate Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
Shu-Hung Chuang, Shih-Chang Chuang, Kung-Kai Kuo, Division of General and Digestive Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
Shu-Hung Chuang, Shih-Chang Chuang, Kung-Kai Kuo, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
Author contributions: Chiu BY and Chuang SH drafted the manuscript; Chuang SH, Chuang SC, and Kuo KK revised the manuscript; All authors have read and approved the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shu-Hung Chuang, MD, PhD, Assistant Professor, Doctor, Surgeon, Surgical Oncologist, Division of General and Digestive Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No. 100 Shih-Chuan 1st Road, Sanmin District, Kaohsiung 80708, Taiwan. atreecsw@hotmail.com
Received: December 6, 2022
Peer-review started: December 6, 2022
First decision: December 26, 2022
Revised: January 18, 2023
Accepted: February 27, 2023
Article in press: February 27, 2023
Published online: March 26, 2023
Abstract

Situs inversus (SI) is a rare congenital condition characterized by a mirror-image transposition of the major visceral organs. Since the 1990s, more than one hundred SI patients have been reported to have successfully undergone laparoscopic cholecystectomy. In these cases, the major problem is to overcome is the left-right condition for right-handed surgeons. Laparoscopic common bile duct exploration (LCBDE), an alternative to treat patients with bile duct stones, has shown equivalent efficacy and is less likely to cause pancreatitis than endoscopic retrograde cholangiopancreatography. Recent updated meta-analyses revealed that a shorter postoperative hospital stay, fewer procedural interventions, cost-effectiveness, a higher stone clearance rate, and fewer perioperative complications are additional advantages of LCBDE. However, the technique is technically demanding, even for skilled laparoscopic surgeons. Conducting LCBDE in patients with difficult situations, such as SI, is more complex than usual. We herein review published SI patients with choledocholithiasis treated by LCBDE, including our own experience, and this paper focuses on the technical aspects.

Keywords: Choledocholithiasis, Choledochotomy, Laparoscopic common bile duct exploration, Single incision, Situs inversus, Transcystic

Core Tip: Laparoscopic common bile duct exploration (LCBDE) is an alternative option to treat choledocholithiasis. Compared to endoscopic retrograde cholangiopancreatography, it has been demonstrated that LCBDE has resulted in shorter hospital stays, fewer procedures, and greater cost-effectiveness in recent studies. Nevertheless, LCBDE is a technically demanding procedure. It is even more challenging in difficult circumstances such as situs inversus (SI). Herein, we present an analysis of published SI patients with choledocholithiasis treated by LCBDE and our own case, and this paper focuses on the technical aspects.