Laparoscopic management of rare “ H type” duplication of gall bladder

Dr Anurag Mishra,Dr Shivanshu Misra,Dr Md Abu Masud Ansari

doi:10.17511/ijoso.2020.i06.03

Abstract

A duplicated gallbladder is a rare congenital anomaly with an incidence of 1:4000 live births. Theycan remain asymptomatic and identified incidentally or present as acute cholecystitis, empyema,torsion, cholecystoenteric fistula, Gall bladder lump, or carcinoma. Here the current case is aboutdiscussing a case of a 25-year-old female who presented with symptomatic gallstone disease with aduplicated gallbladder having multiple stones in both the gallbladders. MRCP performedpreoperatively revealed Y type duplication (double Gall bladder with common cystic duct).Laparoscopic cholecystectomy was performed and it finally revealed H type duplication (double Gallbladder with separate cystic ducts for each Gall Bladder).

Highlights

Gallbladder duplication is a rare congenital anomaly with an incidence of 1 in 4000 live births [1]
There is no sex predilection and they are mostly found in adults incidentally during cholecystectomy or autopsy
The Harlaftis classification (Fig 3) is the most widely used and classifies the duplicated GBs anomalies into 3 types: 01. type I or split primordial group has only one cystic duct draining into the common bile duct

Summary

Introduction

Gallbladder duplication is a rare congenital anomaly with an incidence of 1 in 4000 live births [1]. The Harlaftis classification (Fig 3) is the most widely used and classifies the duplicated GBs anomalies into 3 types: 01. Type I or split primordial group has only one cystic duct draining into the common bile duct These Gallbladders are usually next to each other and share a common GB fossa. At Surgery, both gallbladders were found in a common Gallbladder fossa with minimal adhesions to the omentum It was H-type according to the Harlaftis classification. After meticulous dissection, both cystic ducts and their blood vessels were divided and clipped, and the 2 GBs were successfully resected (Figure 2a,2b). Fig-2: Resected specimen; 2A: Duplicated gallbladders, 2B; Schematic representation of specimen. 2C; Opened gallbladder’s lumen

Discussion

Conclusion