ObjectiveTo summarize experience of endoscopic reverse biliary tract stent placement via choledochus in treatment of situs inversus totalis complicated with choledocholithiasis.MethodThe clinical data of one patient with situs inversus totalis complicated with choledocholithiasis in the Department of Tumor Surgery of Lanzhou University Second Hospital were retrospectively analyzed.ResultsThe ERCP was failed at the first admission, followed by the cholecystectomy plus choledocholithotomy plus T-tube drainage, the stones were removed. Two months later, choledochoscopy revealed multiple choledocholithiasis, then the holmium laser lithotripsy and bile duct stent placement was performed at the secondary admission, the postoperative recovery was good, it had been more than 2 months after the surgery, no stone recurrence occurred.ConclusionEndoscopic reverse biliary tract stent placement via choledochus is feasible, which can be used as an option for treatment of patient with situs inversus totalis complicated with choledocholithiasis.
Objective To summarize the current status and challenges in the diagnosis and treatment of colorectal cancer (CRC) in patients with situs inversus totalis (SIT) , and to provide insights for clinical diagnosis and treatment. MethodsBy literature researching, we systematically reviewed the clinical manifestations, molecular pathogenesis, individualized surgical strategies, and prognosis of SIT-CRC. ResultsCurrent studies indicate a general lack of awareness of SIT-CRC, and its mirror-image anatomy significantly increases diagnostic and therapeutic challenges. SIT-CRC is extremely rare, with tumors predominantly located in the sigmoid colon and ascending colon. Molecular studies suggest that SIT-CRC may harbor unique genetic mutation profiles. Treatment involves using systematic preoperative assessment of vascular variations using three-dimensional CT angiography, multidisciplinary team discussions, and implementation of individualized surgical planning. Postoperative attention should be paid to complication management, individualized adjuvant therapy, and long-term follow-up. ConclusionEnhancing the awareness of SIT-CRC and adopting a systematic, multidisciplinary, and individualized approach are crucial for optimizing patients’ outcomes.
