Bilobed Gallbladder: A Rare Anatomical Variation Discovered During Laparoscopic Cholecystectomy.

Area of Science:

• Gastroenterology
• Surgical Anatomy
• Medical Imaging

Background:

• A bilobed gallbladder is a rare congenital anomaly characterized by two lobes sharing a single cystic duct.
• Preoperative diagnosis is typical, but intraoperative identification is infrequent, with limited data on associated conditions.
• This anatomical variation poses surgical challenges, particularly in achieving the critical view of safety during cholecystectomy.

Observation:

• A 22-year-old male presented with acute cholecystitis and cholelithiasis.
• Initial imaging (ultrasound and MRCP) revealed gallstones and gallbladder distension but did not identify the bilobed anatomy.
• The bilobed gallbladder was discovered intraoperatively during laparoscopic cholecystectomy.

Findings:

• Intraoperative imaging review confirmed the diagnosis of a bilobed gallbladder.
• Laparoscopic cholecystectomy was successfully completed using a dome-down approach.
• No intraoperative or postoperative complications occurred.

Implications:

• Accurate and timely diagnosis of bilobed gallbladder is crucial for surgical planning and patient safety.
• This case contributes to the limited medical literature on managing bilobed gallbladders.
• The dome-down surgical technique proved effective for this rare anatomical variation.