Double gallbladder: a case report and review of literature

Double gallbladder is a rare congenital anomaly occurring in 1 in 4000 births, often found incidentally during surgery. It is classified by Boyden into bilobed gallbladder with a single cystic duct (vesica fellea divisa) or true duplication with separate cystic ducts (vesica fellea duplex).

A 50-year-old male presented with intermittent right upper quadrant abdominal pain for 2 months. Examination revealed icteric sclera and deranged liver function tests. Ultrasonography showed a contracted gallbladder with a dilated common bile duct and a calculus. Magnetic resonance cholangiopancreatography (MRCP) confirmed a V-shaped double gallbladder with a single common cystic duct and filling defect. After treating a concurrent chest infection, laparoscopic cholecystectomy was performed. Intraoperatively, two gallbladders connected by a common cystic duct were found, with a stone in the intrahepatic gallbladder. The postoperative period was uneventful.

Duplicated gallbladder is a rare anatomical variant that can present diagnostic challenges. MRCP is the preferred noninvasive imaging technique for accurate preoperative identification and surgical planning. Laparoscopic cholecystectomy is the treatment of choice in symptomatic cases, with intraoperative cholangiography as an adjunct when diagnosis is unclear. Proper anatomical mapping is essential to prevent complications such as bile duct injury and hemorrhage.

Accurate diagnosis and careful surgical planning are critical in managing double gallbladder cases to avoid iatrogenic injuries. This case highlights the importance of using MRCP and intraoperative cholangiogram for optimal outcomes and adds valuable regional data on this rare anomaly.