Related Experiment Video
Updated: Jan 10, 2026
Laparoscopic Choledochal Cyst Excision and Roux-en-Y Choledochojejunostomy in Adults
Published on: February 28, 2025
Laparoscopic cholecystectomy for double gallbladder with the accessory cystic duct draining into the main pancreatic
Yuki Okazoe1, Hiroaki Yanagimoto2, Daisuke Tsugawa1
1Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan.
Insights
This study reports an extremely rare case of double gallbladder with an accessory cystic duct draining into the pancreatic duct, causing recurrent pancreatitis. Surgical resection and stone removal were successful, highlighting the need for long-term follow-up.
Area of Science:
- Gastroenterology
- Surgical Innovation
- Congenital Anomalies
Background:
- Double gallbladder is a rare congenital biliary anomaly.
- Recurrent acute pancreatitis can be associated with biliary anomalies.
- Pancreaticobiliary maljunction is a distinct condition involving abnormal ductal confluence.
Purpose of the Study:
- To report an extremely rare case of double gallbladder with an accessory cystic duct draining into the main pancreatic duct.
- To describe the diagnostic and therapeutic approach for this unique presentation.
- To review and reorganize classifications of multiple gallbladders.
Main Methods:
- Case presentation of a 14-year-old boy with recurrent acute pancreatitis.
- Diagnostic workup included endoscopic retrograde cholangiopancreatography (ERCP).
- Surgical management involved laparoscopic resection of both gallbladders and accessory cystic duct stone removal with intraoperative cholangiography.
Main Results:
- ERCP revealed an accessory gallbladder draining into the main pancreatic duct with a cystic duct stone.
- Laparoscopic surgery was safely performed.
- Biochemical analysis indicated bidirectional reflux between the biliary system and pancreatic duct.
Conclusions:
- This case highlights a rare double gallbladder variant associated with pancreatitis due to accessory duct drainage into the pancreatic duct.
- Laparoscopic management is feasible and effective.
- Long-term follow-up is crucial due to potential malignancy risk.
Abstract:
Double gallbladder is a rare congenital anomaly of the biliary system. In this study, we present an extremely rare case of a double gallbladder with an accessory cystic duct draining into the main pancreatic duct. The patient was a 14-year-old boy with recurrent acute pancreatitis. Endoscopic retrograde cholangiopancreatography revealed an accessory gallbladder draining into the main pancreatic duct, along with a filling defect suggestive of a stone within the accessory cystic duct. These findings did not suggest pancreaticobiliary maljunction. We safely performed laparoscopic resection of the gallbladder and accessory gallbladder, as well as accessory cystic duct stone removal, using intraoperative cholangiography. Biochemical analysis revealed elevated amylase levels in the gallbladder bile and elevated bilirubin levels in the accessory gallbladder fluid, suggesting bidirectional reflux of pancreatic juice and bile. Given the potential risk of malignancy, careful long-term follow-up is required. In this case report, we reviewed existing classifications of multiple gallbladders and reorganized them based on previously reported cases.
