Intrahepatic Gallbladder

Abstract

Gallbladders have been reported in various ectopic locations. An intrahepatic gallbladder is one where the gallbladder lies within the liver parenchyma or has a subcapsular location along the anterior inferior right lobe of the liver. Intrahepatic gallbladders can have impaired function leading to the formation of gallbladder stones. We present the case of a 57-year-old man who was found to have an intrahepatic gallbladder which was not detected before a retrograde open cholecystectomy was carried out without intra-operative or postoperative complications. Awareness of ectopic gallbladders and their recognition allows proper intra-operative planning. LEARNING POINTS Gallbladder disease in intrahepatic gallbladders poses an additional surgical risk for patients and complicates cholecystectomy or other biliary procedures. Awareness of this rare entity as well as optimum management will prevent patient morbidity and improve outcome. Preoperative MR cholangiopancreatographyis recommended if an intrahepatic gallbladder is identified on ultrasound or CT. Expert hepatobiliary surgeon involvement as well as an intra-operative cholangiogram is recommended in complex cases with abnormal biliary or hepatic vascular anatomy.

Intrahepatic gallbladder duplication mimicking a hepatic cyst: A case report

“…The intrahepatic location, the second commonest ectopic site, may impair the biliary drainage resulting in biliary stasis and cholelithiasis. 7 Ultrasonography is incapable of differentiating intrahepatic gallbladder duplications from mimicking lesions such as a Phrygian capped gallbladder, Todani type II choledochal cysts, 8 gallbladder diverticuli, cystic intraductal papillary neoplasms of the bile duct, and localized Caroli's disease. 9 The sensitivity of ultrasonography and CT in diagnosing duplicated gallbladders is similar at about 60%.…”

“…The intrahepatic location, the second commonest ectopic site, may impair the biliary drainage resulting in biliary stasis and cholelithiasis. 7 …”

A rare case of intrahepatic gallbladder in the setting of penetrating liver injury, a retrospective diagnosis: a case report

“…4 Monib et al concluded that awareness of ectopic gallbladder allows proper preoperative planning and will often require surgery at the earliest due to increased risk of cholelithiasis. 5 Alkatout et al showed that the very rare entity of extra abdominal placed gallbladder in a neonate without the typical cholestasis symptoms. 6 Schultz et al did a report on accurate diagnosis of intrahepatic gallbladder with the help of 99mTc sulfur colloid and 131I-rose bengal in a cirrhotic patient with suspected intrahepatic neoplasm.…”

Gross Dissection of Liver for Hepatocellular Carcinoma Using AJCC Cancer Staging Manual 8th Edition: Anatomical and Practical Considerations

“…The gallbladder is a small sac, which is found on the visceral side of the liver. The gallbladder is adherent to the posterior liver along one side (the gallbladder 'bed'), and in rare cases, is not visible as it can be entirely intrahepatic (3). A thorough inspection should be given in cases of biliary atresia with Kasai porto-enterostomy, because the gallbladder can be very small or absent (4).…”