Anomalies Of Gallbladder Research Articles

Morphological Variations in Gall Bladders of Cadavers

Gall bladder is a pear-shaped pouch located in right hypochondrium, in a shallow fossa on the quadrate lobe of the liver. There are very common variations associated with gall bladder and it is surgeon’s duty to be familiar with them so as to avoid surgical errors. Aim: To describe external morphology, incidence of different shapes of gall bladder and to study variations in gross appearance of gall bladder Material and method: A total number of 50 cadavers were dissected, analyzed using SPSS and tested at 5% level of significance. Results: Out of 50 specimens studied, 92% gall bladders were found to be pear shape, 4% cylindrical, 2% flask shape and 2% irregular. Conclusion: The knowledge of different shapes, variations and anomalies of gall bladder could be useful for radiologists and surgeons to prevent intraoperative hazards.

How to Suspect and Manage an Hypoplasic Gallbladder: A Case Report and Review of Literature

Background: Malformations related to the gallbladder are uncommon, with an incidence lower than 0,1%. The majority of them are asymptomatic, however when symptoms appear are non-specific with a similar presentation to biliary colic. Methods: We report a case of a 29-year-old woman with persistent upper right abdominal pain and no visualization of the gallbladder in the ultrasound (US), CT scan or in the magnetic resonance cholangiopancreatography (MRCP). Results: A laparoscopic exploration was performed due to persistent abdominal pain which confirmed an hypoplasic gallbladder. After cholecystectomy, symptoms were relieved. Herein we propose a decisional algorithm when suspecting a gallbladder with agenesis or hypoplasia. Conclusion: Surgeons need to take into consideration congenital anomalies of the gallbladder. Performing imaging techniques is important in order not to misdiagnose hypoplasia.

Anatomical and congenital anomalies of liver and gallbladder: Its embryogenesis and clinical implications

Anatomical and congenital anomalies of liver and gallbladder: Its embryogenesis and clinical implications

Clinico-functional assessment of the effectiveness of osteopathic correction of biliary disorders in patients with celiac disease

Ntroduction. Celiac disease is a genetically determined disease, which is often associated with the dysplasia of the connective tissue, and may be considered as one of the causes of the secondary biliary dysfunction. Functional alterations play a signifi cant role in the formation of chronic pathology. The basis for osteopathic treatment is the correction of functional alterations, aimed at amelioration of work of the basic elements of the biliary system.Goals of research - to evaluate the clinical effectiveness of osteopathic correction in treatment of biliary dysfunction in patients with celiac disease.Materials and methods. 48 patients (23 men and 25 women) diagnosed with celiac disease aged from 18 to 35 took part in the research. Their average age was 26,5±2,1 years old. All the patients underwent clinical and osteopathic examination, I. A. Alexeev-Berkman coprological examination, ultrasound examination «SonolinePrima LC» («Siemens», Germany) performed according to the standard methodology with the determination of the fraction and the coeffi cient of the evacuation. Patients received osteopathic treatment during two months. Results. The assessment of the diagnostic fi ndings showed that among 48 patients with biliary disorders with a background of different anomalies of the gall bladder 41 (85,4 %) patients suffered from clinical manifestations of the disease. During the osteopathic examination of patients typical somatic dysfunctions were found: regional biomechanical disorders (cervical, thoracic, lumbar and pelvic regions) and local biomechanical disordes (cupula of the diaphragm on the right, lower ribs on the right, ligamentous apparatus of the liver, gall bladder, duodenum). The ultrasound examination of the abdominal organs revealed different anomalies of gall bladder in combination with the alteration of the colloidness of the content of the gall bladder. Statistically signifi cant contingency between the presence of the biliary sludge and the type of anomalies of the gall bladder was determined (χ2=8,12; р=0,017; С=0,55). After the course of osteopathic treatment the main clinical manifestations signifi cantly reduced, the mobility improved in all the regions of the spine, and in the thoracic diaphragm, the importance and the manifestation of somatic dysfunctions decreased in the liver, in the bile ducts, in the stomach, in the duodenum, and in the bone structures of the pelvis (р<0,01). Also the process of digestion improved: creatorrhoea, steatorrhoea, amylorrhea were less expressed (p<0,05), the contractile function of the gall bladder improved (emptying coeffi cient 59,8±1,84 %) and the anechogenic effect was achieved.Conclusion. The use of osteopathic methods showed high effectiveness in treatment of biliary pathologies in patients with celiac disease.

Management of Choledochal Cysts: An Institutional Review

Introduction: Choledochal cysts are congenital abnormalities characterized by cyst formation and dilation of the biliary tree. They are a rare condition more common in females with the highest incidence in the United States estimated at 1 in 13,500 live births (1). They can be clinically silent, cause biliary obstruction and/or transform to malignancy. Management is controversial because statistics regarding malignant transformation vary widely. Estimates from select studies vary from 10% (2) to 26% (3). This study was performed to review the natural history and management of choledochal cysts at our institution. Methods: Patient charts from 2009-2017 were obtained with the following ICD9 and ICD10 codes: Choledochal cyst (Q44.4); biliary cyst (K83.5); other specified disorders of the biliary tract (576.8); anomalies of gallbladder, bile ducts, and liver (751.69); biliary atresia (751.61); other congenital malformations of bile ducts (Q44.5); and intrahepatic bile duct carcinoma (155.1, C22.1). A total of 2,546 charts were identified. Charts were then reviewed for the presence of choledochal cysts. Results: Eleven patients with choledochal cysts were found. Ten out of the 11 were female. Five had Type I cysts (one of these patients also had a Type II cyst). Five had Type II cysts. There was only one patient with a Type III cyst and only one with a Type IV cyst. Five out of the 11 patients with choledochal cysts were managed with surgical removal with either a Roux-en-Y hepaticojejunostomy, Roux-en-Y choledochojejunostomy or Whipple procedure depending on other patient factors. The patient with the Type III cyst was lost to follow-up after diagnosis of the cyst. Conclusion: Management of choledochal cysts at our institution varied with about half opting for surgical removal and half opting for serial follow-up with imaging. Given the rarity of the disease and varied results regarding transformation to malignancy, an individualized patient approach should be taken. Future research aims could include creation of a database of patients with choledochal cysts, given that malignant transformation and management will likely vary by type of cyst, patient characteristics, and patient preference.

Ultrasound imaging of gallbladder variants

IntroductionThis article examines the variations and anomalies of gallbladder. This study is highly useful for surgical purposes where there is always a lot of variations seen, to prevent misdiagnosis and to aid in evaluation of differential diagnostic possibilities. MethodsUltrasonography was used to perform this study. ResultThis study demonstrates wide array of variants including anomalies in location, number and configuration. The present study shows that there is double gallbladder found in 1%, kinking of posterior wall of gallbladder in 15%, Phrygian cap deformity in 7%, curved gallbladder found in 1%, intrahepatic gallbladder observed in 9%, transverse gallbladder detected in 7% and the gallbladder is located under the left lobe of liver in 2% of the cases. Normal location in right Hypochondrium is seen in 81 subjects. DiscussionThe present study shows various anomalies of gallbladder that can be diagnosed prior to the surgery, so as to avoid misdiagnosis that could cause any fatality.

Longest and left-sided gallbladder

As laparoscopic cholecystectomy is one of the most common procedure done worldwide. Although anomalies are rare but are associated with congenital malformations of gallbladder, bile ducts and vascular system. Herein, we present a case of young female presenting with symptoms of pain in right hypochondrium with ultrasonographic diagnosis of cholelithiasis undergone successful laparoscopic cholecystectomy with Intraoperative findings of: 1. The length of the gallbladder was measured to be 25.8 cm. 2. The fundus of the gallbladder was placed to the left of the falciform ligament. The gallbladder then extended to the right of the falciform ligament, reached up to the liver margin before taking a U-turn to lie in the usual gallbladder fossa. Anomalies of gallbladder present an important hurdle in successful laparoscopic cholecystectomy. Most of time not known preoperatively encountered during surgery. Isolated left-sided gallbladders are rare and found in 0.040.3% of cases. When there is question about anatomy of biliary tract intraoperatively one should consider for anomalies. A habit of calm and slow dissection with precautions should be developed. Clearance of the anatomical structures with limited use of electrocautery should be done before proceeding towards ligation or clip applications to structures. A surgeon should be well equipped with knowledge of anomalies of gallbladder and meticulous dissection with good exposure of structures should be done when an anomaly found.

A Study on the Anomalies of Gallbladder and Associated Structures

The gallbladder is a piriform structure on the undersurface of liver. It collects bile from the liver to concentrate it and to store it. The gallbladder has a cystic duct which joins the common bile duct and through these ducts bile passes into the duodenum. There is usually a single gallbladder (arising from the cystic bud of hepatic diverticulum) with one cystic duct supplied by a cystic artery taking origin from the right hepatic artery. But in few persons there are double gallbladder or double cystic ducts or different variations in the origin and course of cystic arteries. A study was undertaken in 2006 to detect the anomalies of these structures among the people Kolkata (a metropolis of eastern part of India), by dissection of cadavers. This study was conducted from the year 2006 to 2009 in the Department of Anatomy of Calcutta National Medical College and in other medical colleges of Kolkata. Three cases of double gallbladder and few other variations like double cystic duct were found in this study. These findings will help the clinicians (specially the surgeons, radiologists of the eastern part of India) to undertake any investigative or surgical procedure in the region of extra hepatic biliary apparatus. This study will enhance our knowledge not only surgical Anatomy, but also in embryology and in gross anatomy.

Triple Gallbladder: A Rare Entity

To the Editor: Triple gallbladder is also called vesica fellae triplex (1). It is one of the very rare congenital anomaly of the biliary tract. According to literature, 11 cases have been reported till now (2). The very first case was reported in a human cadaver in 1752 by Huber (3). Most of the cases of congenital anomalies of gallbladder remain undiscovered and come to attention only when they are associated with symptoms due to cholelithiasis, cholecystitis, biliary sludge, obstructive symptoms, and carcinoma. We report a case of triple gallbladder, which was incidentally diagnosed in a 30-year-old female who presented with complaints of pain in the right hypochondrium. Her radiological investigation revealed a duplication of gallbladder and chronic cholecystitis. However, a third gallbladder was found during surgery.

Anomalies of Gallbladder And Its Frquency

Anomalies of Gallbladder And Its Frquency