Laparoscopic Cholecystectomy and ERCP with Sphincterotomy in a Woman with Situs Inversus Totalis

ABSTRACT

Situs inversus totalis is a mirror image of the normal anatomy in the thoracic and the abdominal cavity. The cardiac apex, the stomach and the aortic arch are all on the right side. It is a rare condition with a genetic predisposition that is autosomal recessive and is associated with a 5-10% incidence of congenital heart disease. In a situs inversus totalis with cholelithiasis and choledocholithiasis, laparoscopic cholecystectomy was performed three days after endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy. In the laparoscopic cholecystectomy, pneumoperitoneum was made by a closed method, and the cholecystectomy was performed using the three trocar technique. Although we should pay much attention to the details of left-right reversal, these techniques can be safely and effectively applied to situs inversus totalis patients.