Laparoscopic observations of congenital anomalies of the liver

Background: A good knowledge of acquired morphologic changes and congenital anomalies requires precise understanding of pathologic conditions of the visceral organs. The aim of the present study was to systematically investigate the types and frequencies of laparoscopically observed congenital anomalies of the liver. Methods: We studied congenital anomalies observed laparoscopically in 1802 consecutive patients who underwent laparoscopy from 1981 to 1994. Results: Congenital anomalies observed laparoscopically were as follows: ape's (monkey's) fissure (6.8%), fissure formation with anomalous lobation (4.3%), left deviation of the round ligament (3.6%), high insertion of the round ligament (2.8%), ectopic liver and accessory lobe of the liver (0.7%), lobar fusion (0.5%), partial defect of the falciform ligament (0.3%), and situs inversus totalis (0.1%). None of these anomalies except situs inversus totalis were diagnosed by imaging techniques other than laparoscopy. Conclusion: Congenital anomalies of the liver are unexpectedly frequent (19.3% of patients) at laparoscopy, which seems to be the most useful method for finding such anomalies. (Gastrointest Endosc 1998;47:136-40.)