Abstract:Double gallbladder is a rare congenital biliary anomaly, but an accessory gallbladder arising from the left hepatic duct is a more remarkably rare congenital anomaly. We report a case of double gallbladder with adenocarcinoma and gallstones, which was preoperatively diagnosed by endoscopic retrograde cholangiopancreatography (ERCP) and then confirmed by open laparotomy. A review of the literature is presented.
“…However, in our case, the serum C-reactive protein level was almost in the normal range on the day of the FDG-PET examination. In the case of Kawanishi et al, the SUV max evaluated by FDG-PET was 4.8, despite the presence of submucosal carcinoma [5]. Although we recognized the importance of FDG-PET, we could not reconcile the differences in these results.…”
Section: Discussionmentioning
confidence: 63%
“…In addition, celiac angiography demonstrated the unusual form of the intrahepatic artery that enveloped the cystic tumor, and they noted that it might be a diagnostic characteristic of accessory gallbladders. Kawanishi et al reported carcinoma visualized with abnormal accumulation by FDG-PET [5]. Well-differentiated tubular adenocarcinoma with infiltration into the submucosal layer was observed in the resected accessory gallbladder.…”
Section: Discussionmentioning
confidence: 98%
“…Studies on MGs were identified in PubMed by searching for the words "multiple gallbladders," "duplicated gallbladder," "duplication of gallbladder," "duplicate gallbladder," and "double gallbladder" corresponding to the definition of true duplication according to Boyden's classification. Furthermore, only five cases of gallbladder malignancy with MGs, except for MGs in a broad sense, have been reported in the English literature [2][3][4][5][6]; little is known about MGs associated with carcinoma. We herein report a rare case of MGs associated with carcinoma.…”
Introduction: Multiple gallbladders represent a rare congenital disorder, and coexistence with carcinoma is extremely rare, leading to a high possibility of misdiagnosis and surgical complications. In this study, a case was reported and the literature was reviewed. Case presentation: An 80-year-old woman was diagnosed with acute cholecystitis via ultrasonography and was successfully treated with antibiotics. After the patient's biliary colic relapsed, she was referred to our hospital. Multiple imaging modalities revealed duplication of her gallbladder (H-type) and suggested coexistence with carcinoma. According to preoperative evaluations, we assumed the patient had stage IIIA disease, and cholecystectomy, cholangiography using a near-infrared ray vision system, and sectionectomy of segments 4a and 5 were performed. Contrary to the high standardized uptake values obtained by 18 F-fluoro-2-deoxy-D-glucose positron emission tomography, gallbladder carcinoma was pathologically diagnosed as stage 0 mucosal cancer. Seven days after the operation, portal thrombosis of the posterior branch was revealed, and conservative therapy was indicated; satisfactory results were achieved. The patient was discharged 65 days after surgery. No recurrence was observed for 1 year after surgery. Conclusions: An extremely rare case of malignancy in a duplicated gallbladder was reported, and the literature was reviewed. Accurate estimations are feasible for diagnoses of multiple gallbladders, where correct evaluations are vital, especially in malignant cases. Because of the possibility of malignancy, resected accessory gallbladders should be scrutinized pathologically.
“…However, in our case, the serum C-reactive protein level was almost in the normal range on the day of the FDG-PET examination. In the case of Kawanishi et al, the SUV max evaluated by FDG-PET was 4.8, despite the presence of submucosal carcinoma [5]. Although we recognized the importance of FDG-PET, we could not reconcile the differences in these results.…”
Section: Discussionmentioning
confidence: 63%
“…In addition, celiac angiography demonstrated the unusual form of the intrahepatic artery that enveloped the cystic tumor, and they noted that it might be a diagnostic characteristic of accessory gallbladders. Kawanishi et al reported carcinoma visualized with abnormal accumulation by FDG-PET [5]. Well-differentiated tubular adenocarcinoma with infiltration into the submucosal layer was observed in the resected accessory gallbladder.…”
Section: Discussionmentioning
confidence: 98%
“…Studies on MGs were identified in PubMed by searching for the words "multiple gallbladders," "duplicated gallbladder," "duplication of gallbladder," "duplicate gallbladder," and "double gallbladder" corresponding to the definition of true duplication according to Boyden's classification. Furthermore, only five cases of gallbladder malignancy with MGs, except for MGs in a broad sense, have been reported in the English literature [2][3][4][5][6]; little is known about MGs associated with carcinoma. We herein report a rare case of MGs associated with carcinoma.…”
Introduction: Multiple gallbladders represent a rare congenital disorder, and coexistence with carcinoma is extremely rare, leading to a high possibility of misdiagnosis and surgical complications. In this study, a case was reported and the literature was reviewed. Case presentation: An 80-year-old woman was diagnosed with acute cholecystitis via ultrasonography and was successfully treated with antibiotics. After the patient's biliary colic relapsed, she was referred to our hospital. Multiple imaging modalities revealed duplication of her gallbladder (H-type) and suggested coexistence with carcinoma. According to preoperative evaluations, we assumed the patient had stage IIIA disease, and cholecystectomy, cholangiography using a near-infrared ray vision system, and sectionectomy of segments 4a and 5 were performed. Contrary to the high standardized uptake values obtained by 18 F-fluoro-2-deoxy-D-glucose positron emission tomography, gallbladder carcinoma was pathologically diagnosed as stage 0 mucosal cancer. Seven days after the operation, portal thrombosis of the posterior branch was revealed, and conservative therapy was indicated; satisfactory results were achieved. The patient was discharged 65 days after surgery. No recurrence was observed for 1 year after surgery. Conclusions: An extremely rare case of malignancy in a duplicated gallbladder was reported, and the literature was reviewed. Accurate estimations are feasible for diagnoses of multiple gallbladders, where correct evaluations are vital, especially in malignant cases. Because of the possibility of malignancy, resected accessory gallbladders should be scrutinized pathologically.
“…Kawanishi et al (18) reported a double gallbladder with an adenocarcinoma originating in the left hepatic duct. Nayak et al (17) reported a case concerning a double gallbladder completely enclosed in a cystogastric peritoneum fold.…”
A double gallbladder is a rare congenital malformation. The present study describes a case of double gallbladder with secondary common bile duct stones. By way of laparoscopic choledochoscopy, the exploration and removal of a common bile duct stone was performed through the cystic duct. The process involved a primary suture of the cystic duct and was performed without using a T-tube, and completed a surgical removal of the gallbladder. The present case was successfully treated by laparoscopic surgery. From a review of previous studies published in the English language, this study, to the best of our knowledge, is the first report of such a case. Therefore, laparoscopic dissection is safe for the removal of a double gallbladder and for exploration of the common duct by choledochoscopy.
“…Reports have been published of accessory gallbladders arising from either the left or right hepatic duct but to our knowledge none have shown an accessory gallbladder branching from both the left and right hepatic ducts. Figure 4 Harlaftis classification for accessory gallbladders (adapted from Kawanishi et al ) 4 …”
We present a case of accessory gallbladder demonstrating an anatomical variation not previously reported. While rare, accessory gallbladders are an important consideration if a cholecystectomy is to be performed. We also present a brief literature review of accessory gallbladders.
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