J Korean Med Sci.  2017 Mar;32(3):552-555. 10.3346/jkms.2017.32.3.552.

Unsuspected Duplicated Gallbladder in a Patient Presenting with Acute Cholecystitis

• Lee W
• Song DH
• Lee JK
• Park JH
• Kim JY
• Kwag SJ
• Park T
• Jeong SH
• Ju YT
• Jung EJ
• Lee YJ
• Hong SC
• Choi SK
• Jeong CY

• KMID: 2366655
• DOI: http://doi.org/10.3346/jkms.2017.32.3.552

Abstract

Duplicated gallbladder (GB) is a rare congenital disease. Surgical management of a duplicated GB needs special care because of concurrent bile duct anomalies and the risk of injuring adjacent arteries during surgery. An 80-year-old man visited an emergency room with right upper quadrant abdominal pain. Computed tomography (CT) revealed cholecystitis with a 2-bodied GB. Because of this unusual finding, magnetic resonance choledochopancreatography was performed to detect possible biliary anomalies. The 2 GB bodies were unified at the neck with a common cystic duct, a so-called V-shaped duplicated GB. The patient's right posterior hepatic duct joined the common bile duct (CBD) near the cystic duct. The patient underwent laparoscopic cholecystectomy without adjacent organ injury, and was discharged uneventfully. Surgeons should carefully evaluate the patient preoperatively and select adequate surgical procedures in patients with suspected duplicated GB because of the risk of concurrent biliary anomalies.

Keyword

Duplicated Gallbladder; Cholecystitis; Cholecystectomy; Laparoscopy

MeSH Terms

Abdominal Pain
Aged, 80 and over
Arteries
Bile Ducts
Cholecystectomy
Cholecystectomy, Laparoscopic
Cholecystitis
Cholecystitis, Acute*
Common Bile Duct
Cystic Duct
Emergency Service, Hospital
Gallbladder*
Hepatic Duct, Common
Humans
Laparoscopy
Neck
Patient Rights
Surgeons

Figure

• 

  Fig. 1 Magnetic resonance choledochopancreatography reveals V-shpaed duplicated GB with right hepatic duct anomaly. (A) GB 1 was inserted into the neck of the other GB (GB 2). (B) The right posterior bile duct (arrow) joined the CBD near the common cystic duct. GB = gallbladder, CBD = common bile duct.

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  Fig. 2 Macroscopic view (A) of the specimen and microscopic features of the duplicated GB (B). The GB body shows separation of the lamina propria and muscle layer (arrowhead). Perimuscular connective tissue (arrow) is shared between the GB 2 bodies with H & E staining (× 40). GB = gallbladder, H & E = hematoxylin and eosin.

• 

  Fig. 3 Classification of duplicated GB. Adapted from Harlaftis et al. (1). GB = gallbladder.

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