Laparoscopic cholecystectomy in double gallbladder with dual pathology

Area of Science:

• Gastroenterology and Hepatobiliary Surgery
• Embryology and Developmental Biology

Background:

• Double gallbladder is a rare embryological anomaly with significant clinical implications.
• Preoperative diagnosis of this anomaly is crucial for preventing operative complications, yet remains challenging.

Observation:

• The case involved a symptomatic young male presenting with dyspepsia, abdominal pain, and fever.
• Diagnostic imaging, including ultrasound and magnetic resonance cholangiopancreatography, confirmed a double gallbladder.
• One gallbladder lobe presented with calculous cholecystitis, while the other showed acalculous empyema.

Findings:

• The first gallbladder lobe drained into the common bile duct (CBD) via its cystic duct.
• The second gallbladder lobe was a blind vesicle, lacking communication with the CBD or the other gallbladder.
• This case highlights the extreme rarity of double pathology within a double gallbladder anomaly.

Implications:

• Accurate preoperative diagnosis of double gallbladder is vital for successful laparoscopic cholecystectomy.
• Surgeons and radiologists must maintain high awareness of this anomaly to ensure patient safety.
• While laparoscopic approaches are feasible, a low threshold for conversion to open surgery is recommended in complex cases.