Laparoscopic Cholecystectomy in Situs Inversus Totalis, Challenges From the Surgeon’s Perspective: A Case Report

Prapanca Nugraha¹, Andrianto Andrianto², Reno Rudiman³

Keywords: Situs inversus totalis, cholelithiasis, cholecystitis, laparoscopic cholecystectomy, case report

DOI: 10.63475/yjm.v4i1.0158

DOI URL: https://doi.org/10.63475/yjm.v4i1.0158

Publish Date: 22-09-2025

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Pages: 452 - 456

Citation: 0

Author Affiliation:

1 General Surgeon, Department of Surgery, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
2 Gastrointestinal Surgeon, Department of Surgery, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
3 Professor/Gastrointestinal Surgeon, Department of Surgery, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia

Abstract

Situs inversus totalis (SIT) is a rare birth defect marked by a complete reversal of the positions of abdominal and thoracic organs, resembling a mirrored image. This condition can raise challenges both in diagnosis and treatment procedures. Management of cholelithiasis in SIT patients presents difficulties due to the anatomical differences. We present a case involving a 47-year-old male patient who experienced intermittent left upper abdominal pain over the course of 4 months; the pain had worsened in the last 2 months. The pain was felt radiating to the waist and left back and was accompanied by nausea and vomiting. After clinical assessment and radiological investigations, such as thoracic X-ray and abdominal ultrasound, the patient was suspected of having cholelithiasis and SIT. The patient underwent an elective laparoscopic cholecystectomy without complications and experienced an uneventful recovery. Several intraoperative adjustments were implemented to address the technical challenges arising from the underlying anatomical variation.

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