Laparoscopic treatment of gallbladder duplication

Abstract

This case illustrates the need for complete removal of both gallbladders during initial surgery. Precise intraoperative recognition of vascular and biliary anatomy-including abnormalities-is highlighted to avoid mistakes during surgery.

Congenital anomalies and variations of the bile and pancreatic ducts: magnetic resonance cholangiopancreatography findings, epidemiology and clinical significance

“…One anatomical variant observed in our study, which causes important clinical, diagnostic and surgical problems, is a double gall bladder; this variant has an incidence of one subject in 4,000 [19]. The complications associated with a double gall bladder include calculosis, torsion and development of papilloma, carcinoma, obstruction of the common bile duct and secondary bile cirrhosis [20]. The anatomical variants of a double gall bladder are still differentiated according to the Boyden classification [21]: -Externally normal gall bladder divided internally by a longitudinal septum -Bifid gall bladder from which a single cystic duct emerges -Double gall bladder with two cystic ducts that unite to form a common duct before the confluence into the hepatic duct -Double gall bladder with two cystic ducts draining separately into the common hepatic duct The preoperative diagnosis of double gall bladder is fundamental, especially if laparoscopic cholecystectomy is programmed.…”

“…Le complicanze associate a colecisti doppia includono la calcolosi, la torsione e lo sviluppo di papilloma, carcinoma, ostruzione del dotto comune e cirrosi biliare secondaria [20]. Le varianti anatomiche della doppia colecisti sono ancora differenziate secondo la classificazione di Boyden [21]: -colecisti esternamente normale ma divisa internamente da un setto longitudinale; -colecisti bifida dalla quale emerge un unico dotto cistico; -doppia colecisti con due dotti cistici che si uniscono a formare un dotto comune prima della confluenza nel dotto epatico; -doppia colecisti con due dotti cistici drenanti separatamente nel dotto epatico comune.…”

Gallbladder duplication: imaging findings and differential considerations

“…If not preoperatively diagnosed, the second gallbladder may be overlooked during surgery, especially if it is intrahepatic. The importance of the preoperative diagnosis of gallbladder duplication, especially when considering laparoscopic cholecystectomy, has been determined in the literature [11][12][13]. Removal of both gallbladders at surgery is recommended.…”

Missed Preoperative Diagnosis of a Double Gallbladder with Cholelithiasis in the Era of Advanced Imaging: A Rare Case Report

“…4 It is important to diagnose this anomaly pre-operatively because the second gallbladder may be overlooked during surgery. 5 Although in the past these anomalies couldn't be revealed by traditional methods of diagnosis, nowadays it can be easily diagnosed by magnetic resonance imaging, 6 computerized tomography, or even by an ultrasound performed by an experienced radiologist.…”