Clinical significance and outcomes of left-sided gallbladder for cholecystectomy: A retrospective cohort study based on 12-year single-center experience.

BACKGROUNDS/AIMS: Left-sided gallbladder (LSG) is a rare biliary anomaly where the gallbladder (GB) is situated to the left of the ligamentum teres, without situs inversus. Most cases are not preoperatively identified during routine evaluations, which tend to focus more on surgical pathology than detailed anatomical variations. This study investigated the clinical implications of LSG in patients undergoing cholecystectomy.

METHODS

We retrospectively reviewed 7,487 consecutive cholecystectomies performed at a single center between June 2014 and October 2025. LSG was confirmed by intraoperative findings and operative photographs/videos. The indication for surgery, operative time, GB perforation, drain insertion, and postoperative complications were assessed and compared with non-LSG cases.

RESULTS

LSG was identified in 23 patients (0.3%). Mean operative time was comparable between LSG and non-LSG groups (43.5 vs. 42.4 min, p = 0.845). GB perforation rates were similar (17.4% vs. 17.8%, p = 0.964). Drain insertion was less frequent in LSG patients, although this did not reach statistical significance (8.7% vs. 27.3%, p = 0.046; continuity-corrected p = 0.078). No intraoperative or postoperative complications, including bile duct injury, occurred in the LSG group. Preoperative imaging failed to diagnose any case of LSG.

CONCLUSIONS

The incidence of LSG (0.3%) in our series was consistent with previous reports. Standard laparoscopic cholecystectomy can be performed in most LSG cases. Nonetheless, surgeons should remain alert to the possibility of associated biliary or vascular anomalies to ensure safe dissection.