Pancreatic bladder or double gallbladder draining into pancreatic duct?

Area of Science:

• Gastroenterology and Hepatobiliary Surgery
• Congenital Anomalies
• Anatomical Variations

Background:

• Biliary ductal system anomalies are uncommon, presenting diagnostic and therapeutic challenges.
• The case involves a rare presentation initially diagnosed as gallbladder duplication in a pediatric patient.

Observation:

• A 6-year-old boy underwent cholecystectomy for a smaller gallbladder, presumed to be duplication.
• Histological analysis confirmed gallbladder-like tissue in the removed aberrant structure.
• At age 25, relaparotomy revealed the aberrant duct directly connected to the pancreatic duct (duct of Wirsung) and fusiform dilatation of the extrahepatic bile duct.

Findings:

• The anomaly, termed pancreatic bladder, involves a cystic duct directly joining the pancreatic duct.
• This condition can also be interpreted as a double gallbladder anomaly with unusual drainage.
• Surgical management included excision of the extrahepatic bile duct, the remaining gallbladder, and the aberrant duct.

Implications:

• This case validates the concept of a pancreatic bladder, highlighting a rare congenital biliary anomaly.
• Understanding such anomalies is crucial for accurate diagnosis and surgical planning in hepatobiliary conditions.
• Further research into the embryological origins of these dual gallbladder and pancreatic duct anomalies is warranted.