1.Laparoscopic cholecystectomy and common bile duct exploration for gallstone and common bile duct stone in a patient with a left-sided gallbladder:a case report
Takeshi UEDA ; Tetsuya TANAKA ; Yuki KIRIHATAYA ; Chisato HARA ; Atsushi YOSHIMURA
Journal of Minimally Invasive Surgery 2023;26(4):218-221
Left-sided gallbladder is a rare finding that is mostly discovered incidentally during surgery and is often associated with anatomic anomalies. We herein report a case in which laparoscopic cholecystectomy and common bile duct exploration were achieved for an 89-year-old female patient with left-sided gallbladder. Surgery was carried out using our usual trocar position.Calot triangle was covered by the body of the gallbladder and could not be detected. We dissected the gallbladder from the fundus towards the neck. The cystic duct joined the common bile duct from the right side, and common bile duct exploration was performed routinely without perioperative comorbidities. Although the preoperative diagnosis rate is low and the risk of intraoperative bile duct injuries in patients with left-sided gallbladder is high, laparoscopic cholecystectomy and common bile duct exploration can be safely performed by understanding the location and bifurcation of the cystic duct.
2.A Case of Decreased Swallowing Function Due to Cardiac Myxoma
Sumiyo AKAZAWA ; Seiko MIURA ; Yasuhiro NAGAYOSHI ; Junya FUKUSHIMA ; Takahiro NISHINO ; Hiroji NAGATA ; Taigo NAGAYAMA ; Kazuaki NISHIKI ; Taishi FUJII ; Daisuke SAKAMOTO ; Tetsuya MINAMI ; Taketsugu TSUCHIYA ; Hidetaka URAMOTO ; Shigeru KUDOH ; Tamaki TAKANO ; Takaki MIWA ; Michihiko KITAYAMA ; Shigeru SKAMOTO
An Official Journal of the Japan Primary Care Association 2022;45(1):31-35
The case was a 77-year-old man. He had dizziness and dysphagia for 2 years, and underwent detailed screening at the internal medicine department for general malaise and bloody sputum. He was hospitalized for aspiration pneumonia due to dysphagia of unknown origin. This time, he visited a local doctor with palpitations and shortness of breath. Echocardiography indicated a left atrial tumor involving the mitral valve and arrhythmia. Emergency surgery was performed to remove the left atrial myxoma and close the patch at our hospital's cardiovascular surgery department. After the excision, swallowing function was restored, and the patient was diagnosed with postoperative Ortner's syndrome. We report a case where echocardiography was considered important as a detailed investigation of the cause of swallowing dysfunction and dizziness.