Accessory gallbladder originating from the right hepatic duct

A patient with symptomatic cholecystolithiasis underwent laparoscopic cholecystectomy after confirmation of the diagnosis by sonography. Intraoperative cholangiography was normal and the operation was completed laparoscopically. Due to the postoperative persistence of right upper abdominal pain, another sonogram and then an endoscopic retrograde cholangiogram (ERCP) were performed. To our surprise, an accessory gallbladder with a remaining gallstone was revealed. The accessory cystic duct was shown as arising directly from the right hepatic duct. The patient underwent a second laparoscopic cholecystectomy, but due to hemorrhaging the operation had to be converted to an open procedure. The two gallbladders and their corresponding cystic ducts and arteries were entirely separate. To our knowledge, this is the first publication of a duplicate gallbladder where the cystic duct arose directly from the right hepatic duct.