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Duplicated gallbladder with double cystic duct: hidden in plain sight
Wei S Poh1, Tulsi Menon1, Ruwan Wijesuriya1
1Department of General Surgery, St John of God Midland Hospital, Midland WA, Australia.
Journal of Surgical Case Reports
|February 3, 2022
Summary
A rare duplicated gallbladder with two cystic ducts was found in a 76-year-old man. This case highlights the importance of intraoperative cholangiography to prevent bile duct injuries during gallbladder surgery.
Area of Science:
- Gastroenterology
- Surgical Anatomy
- Medical Imaging
Background:
- Duplicated gallbladder with double cystic duct is an extremely rare congenital anomaly.
- Accurate preoperative diagnosis is crucial for surgical planning and preventing complications.
Observation:
- A 76-year-old male presented with acute cholecystitis, managed conservatively initially.
- Laparoscopic cholecystectomy revealed a duplicated gallbladder with two bile-flowing structures.
- Preoperative imaging (CT, MRCP) did not fully delineate the anomaly.
Findings:
- Postoperative CT cholangiogram confirmed two separate cystic ducts originating from a duplicated gallbladder.
- Subtotal cholecystectomy was performed due to surgical complexity.
- Intraoperative cholangiography is essential for identifying biliary anomalies.
Implications:
- Anatomical variations can be missed even with advanced imaging, increasing the risk of biliary tree injury.
- Routine intraoperative cholangiography is recommended to prevent bile duct injuries.
- Complete removal of both gallbladders is advised to prevent disease recurrence.
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