Gallbladder Duplication Research Articles

The surgical management of a diabetic patient with gallbladder duplication complicated by acute cholecystitis: Case report

The surgical management of a diabetic patient with gallbladder duplication complicated by acute cholecystitis: Case report

Sonographic Diagnosis of Choledochal Cyst in an Infant: A Case Report

A choledochal cyst is traditionally considered as a cystic dilatation of the extrahepatic bile ducts. The exact etiology remains unknown; leading to postulation of multiple theories. Regional variations exist for describing the epidemiology of the disease condition. Most of the cases are diagnosed in early childhood. Differential diagnoses include hepatic cysts, duodenal atresia, gallbladder duplication and so on. Ultrasonography is the imaging method of choice. Regarding treatment, all cysts should be resected and bile flow should be restored. Studies suggest that a certain amount of these cysts turn into cancer; the prognosis of those who develop a malignancy is poor, with a 5-year survival rate of around 5%. Other complications could be ascending cholangitis, stricture and stone and sludge formation. To achieve the best results in the care and management of patients with choledochal cysts, it is essntial to form an interprofessional group of specialists including pediatric surgeons, pediatric gastroenterologists, pathologists, physiotherapists, nutritionists, oncologists and radiologists.

Giant gallbladder cyst with acute cholecystitis: a case report

BackgroundGallbladder cysts are rare diseases with very few reported cases, and no clinical or histological definition has been established. Furthermore, cases of giant cysts outside the gallbladder wall are extremely rare. We report a rare case of giant gallbladder cyst with acute cholecystitis.Case presentationAn 85-year-old woman with appetite loss and right lower abdominal pain lasting 2 days presented to our hospital. At first, the patient’s abdominal pain was mild to moderate with no fever. Blood tests revealed a white blood cell count of 10,950/mm3, and the C-reactive protein (CRP) level was 14.35 mg/dl. A contrast-enhanced computed tomography (CT) scan of the abdomen revealed a grossly distended gallbladder (14.5 × 14.5 × 8.7 cm) with an incarcerated stone in the cystic duct. The patient was treated by percutaneous transhepatic gallbladder drainage (PTGBD) with 735 ml of drainage fluid. Oral contrast magnetic resonance cholangiopancreatography (MRCP) revealed that gallbladder swelling remained (14.0 × 6.5 cm) 3 days after PTGBD. We performed laparoscopic cholecystectomy 6 days after PTGBD. Because of the severe adhesion around the junction of the cystic and common bile ducts, we performed open cholecystectomy.The resected specimen was 14 × 11 cm in size and consisted of a gallbladder (6 × 7 cm) with a stone (2.4 × 1.8 cm) in the gallbladder and a large cystic lesion (18 × 18 cm) outside the gallbladder wall. The cystic lesion had a wall thickness of 6 to 12 mm and internal septal structures and contained hemorrhagic and necrotic tissue.Histological examination revealed that the specimens showed a mildly swollen gallbladder and a cystic lesion on the outside of the gallbladder wall, adjacent to the gallbladder wall, with wall thickening and inflammation. The cystic lesion suggested gallbladder duplication, gallbladder diverticulum or extension of the Rokitansky-Aschoff sinus (RAS). There was no malignancy. The patient’s postoperative course was uneventful, and she was discharged 5 days after the operation.ConclusionWe present a very rare case of giant gallbladder cyst with acute cholecystitis revealed by cholecystectomy.

A new variant of gallbladder duplication mimicking a choledochal cyst: stepwise management of an unexpected surgical finding.

We present a case of previously unclassified duplicated gallbladder which posed a surgical challenge intraoperatively by mimicking a choledochal cyst. An intraoperative cholangiogram was performed followed by a simple cholecystectomy. No further dissection was performed to avoid bile duct injury and complication from the unconventional anatomy. Postoperative imaging and histology, followed by the second operation confirmed findings consistent with the duplicated gallbladder. Through this case, we have demonstrated the principles of safe cholecystectomy and the importance of a staged approach in an unanticipated encounter of anatomical uncertainty, as well as the description of a new variant of duplicated gallbladder.

Diprosopus Tetraophthalmus with Double Outlet Right Ventricle, Congenital Diaphragmatic Hernia, and Duplicated Gall Bladder on Targeted Antenatal Ultrasound with Postnatal Ultrasound and Computed Tomography Correlation

Diprosopus Tetraophthalmus with Double Outlet Right Ventricle, Congenital Diaphragmatic Hernia, and Duplicated Gall Bladder on Targeted Antenatal Ultrasound with Postnatal Ultrasound and Computed Tomography Correlation

Gallbladder duplication

Gallbladder duplication

Complex duplication anomalies of the gall bladder

We discuss two patients of complex duplication of gall bladders with variants which have not been described earlier so far. The duplication of gall bladder is an uncommon type of anomaly with incidence of 1 in 4000 patients. Two classification systems by Harlafti and Gross are used to describe the type of anomalies. In this paper we describe two types of duplications of gall bladder one having left double sided gall bladder and the second with asymmetric small size gall bladder with absent cystic duct both of which pose not only diagnostic but surgical implications. The knowledge of both these types is important to both the diagnostician as well as the surgeon in order to prevent complications and obtain accurate results.

Intraoperative Diagnosis and Management of Duplicated Gallbladder: A Case Report

Laparoscopic cholecystectomy (LC) is the most common elective laparoscopic procedure performed globally and is the gold standard treatment for gallstone disease. A double gallbladder (GB), with or without duplication of cystic duct is a very rare surgical encounter, with an incidence of approximately 1 in 4000–5000 population.Symptomatic conditions of duplicated gallbladder are usually associated with cholecystitis, cholangitis, gallstone disease, and pancreatitis but are rarely diagnosed with carcinoma. Surgery is the ideal treatment choice of symptomatic duplicated gallbladder.Duplication of the GB is rarely detected preoperatively, can lead to difficulties during surgery with increased likelihood of conversion to open surgery and complications. Our patients is a 45-year-old woman admittedas case of symptomatic cholelithiasis. Patient was admitted to the hospital for laparoscopic Cholecystectomy. Preoperative investigations showed that the patient had only Gallstones. Intraoperatively, patient was found to have double gallbladder with double cystic duct.Subsequently,we successfully performed laparoscopic Cholecystectomy after carful identification and dissection of all these critical structures. The patient's recovery was uneventful, and she was discharged on day one post op.All surgeons should be aware of this rare congenital abnormality of the gallbladder, in addition, thorough knowledge of the anatomical variations of the gallbladder and cystic duct greatly aids the surgeon in anticipating duplications, managing it accordingly and avoiding any complications.

Preparing for trouble and making it double: The challenges in the diagnosis and management of the duplicate gallbladder

Preparing for trouble and making it double: The challenges in the diagnosis and management of the duplicate gallbladder

Laparoscopic cholecystectomy for double gallbladder

Gallbladder duplication is a rare abnormality of the biliary system. When a pathology develops in a doubled gallbladder, there can be difficulties in diagnosis and surgical treatment. Apart from the ultrasound investigation, other imaging methods are of great importance for more accurate diagnostics: computed tomography, magnetic resonance tomography, magnetic resonance cholangiopancreatography and endoscopic ultrasonography. The article presents a literature review and demonstrates our own clinical case of laparoscopic cholecystectomy in the patient with gallbladder duplication.

Duplication of the Gallbladder: A Case Report

Gallbladder duplication is a rare congenital anomaly, which is not accompanied by specific symptoms; however, it is usually associated with cholelithiasis. A 52-year-old man is described, who was referred to the hospital complaining of pain. Ultrasonography indicated the presence of Boyden’s Type II gallbladder duplication with stones in the left gallbladder and cholecystitis in both gallbladders. The patient underwent cholecystectomy. In the pathology report, chronic inflammation of the gallbladder was reported. Furthermore, the presence of a second gallbladder was confirmed.

Gall Bladder Duplication: An Interesting Report of Laparoscopic Cholecystectomy performed on Two Cases of Gall Bladder Duplication over a Period of One Week

Gall Bladder Duplication: An interesting report of laparoscopic cholecystectomy performed on two cases of Gall Bladder Duplication over one week.

Gallbladder duplication accompanied by gallstones: A rare congenital anomaly

Gallbladder diseases are among the most common pathologies requiring surgical intervention in general surgery practice. Gallbladder duplication is a rare anomaly of the biliary system. Congenital anomalies and anatomical variations of the gallbladder constitute one of the significant difficulties encountered by surgeons since these variations can cause great uncertainty in defining the anatomical structures of the gallbladder and may lead to significant complications during surgery. Congenital malformations are important predisposing factors for iatrogenic bile duct injuries during cholecystectomy. This case report presents a case of symptomatic gallbladder duplication and a double cystic duct treated with laparoscopic cholecystectomy.

A 'twist' in the tale of a 'simple' laparoscopic cholecystectomy: Duplication of the gall bladder.

The duplication of the gall bladder (GB) is unusual biliary anatomy that can be encountered during cholecystectomy and can create intraoperative confusion if missed on pre-operative imaging. Here, we describe a case of duplication of GB in a young female, which was detected during laparoscopic cholecystectomy as an operative surprise. Laparoscopic cholecystectomy was done successfully with the removal of both the GBs. She was discharged uneventfully and remained symptom-free at a 6-month follow-up.

Repeat Laparoscopic Cholecystectomy for Duplicated Gallbladder After 16-Year Interval.

Gallbladder duplication can present a diagnostic challenge, particularly in patients who have had prior cholecystectomy with a missed duplicated gallbladder. Presented is the case of a man with 16 years of recurrent, persistent right upper quadrant pain after cholecystectomy who was found to have a duplicated gallbladder. Gallbladder duplication can be difficult to diagnose and frequently evades preoperative visualization. In particular, patients who have had prior operations or infections that may lead to epigastric adhesions are at higher risk for a missed gallbladder duplication at time of operation. An intraoperative cholangiogram should be routinely performed when the inferior liver margin is poorly visualized due to scarring or patient habitus. Gallbladder anomalies should be considered in the differential preoperatively for all patients undergoing hepatobiliary procedures and for postoperative patients with persistent biliary symptoms.

СЛОЖНОСТИ ДИАГНОСТИКИ УДВОЕНИЯ ЖЁЛЧНОГО ПУЗЫРЯ СО СТРИКТУРОЙ ДИСТАЛЬНОГО ОТДЕЛА ОБЩЕГО ЖЁЛЧНОГО ПРОТОКА

Objective: Gallbladder duplication is a congenital malformation, is rarely recognized in childhood and occurs in 1 in 4,000 live births. Often, abnormalities in the development of the biliary tract are detected on abdominal imaging or accidentally during surgery in adult patients for an unrelated condition. In this article, the authors describe the complexity of diagnosing a combination of duplication of the gallbladder and stricture of the common bile duct in a 14-year-old child and analyze the diagnostic and tactical errors in the surgical treatment that resulted in the failure to timely diagnose the stricture of the common bile duct. In our opinion, timely diagnosis and proper surgical technique in combined hepatobiliary disorders in children are difficult, even for experienced professionals. However, adequate clinical manifestations assessment, considering an alternative explanation for the presenting symptoms, and timely correction of management errors in the preoperative period could lead to better treatment outcomes. Keywords: Hepatobiliary system, congenital anomalies, gallbladder duplication, stricture of the common bile duct, pediatric.

A rare case of double gall bladder: a case report and review of literature

Double gall bladder is a rare congenital anomaly of the Hepatobiliary system with an incidence of 1:4000 due to abnormalities resulting during the embryogenesis during fourth to sixth week of gestation. Boyden was first to describe the duplication of the gallbladder and Harlaftis classification describes three types for the duplication of the gallbladder. Preoperative diagnosis of the duplication of the gallbladder has to be confirmed to minimise the complications during the surgery and post operatively. Sometimes the duplication of the gallbladder is missed preoperatively and hence increasing the risk and complications during the cholecystectomy. MRCP is the investigation of choice for preoperative diagnosis of the duplication and the laparoscopic cholecystectomy being the treatment of choice for the double gallbladder. We encountered a 25 year old girl with duplicate gallbladder who underwent laparoscopic cholecystectomy with removal of both gallbladders successfully.

Gallbladder duplication complicated by cholecystitis and unsuspected choledocholithiasis: A case report and review of literature.

IntroductionGallbladder duplication is a rare congenital anomaly of the biliary tree. Although a double gallbladder by itself is not clinically significant, complications of gallstone disease increases the complexity of the management. Preoperative recognition decreases the risk of complications during laparoscopic cholecystectomy.Presentation of casePresented herein is the case of a 52 year old who presented with abdominal pain. A transabdominal ultrasound was suggestive of a gallbladder duplication with the larger gallbladder filled with cholelithiasis. Subsequent imaging studies, including an endoluminal ultrasound, confirmed the diagnosis and documented a choledocholithiasis. Endoscopic extraction of the biliary stone with subsequent laparoscopic cholecystectomy of both gallbladders was successfully performed.DiscussionThis case is being presented not only for the rarity of the condition but also of the challenges in management it poses. In gallbladder duplication, pathologic involvement of one gallbladder requires removal of both gallbladders. A high index of suspicion on initial scanning warrants further delineation of the important anatomic structures of the biliary tree to avoid perioperative complications.ConclusionLaparoscopic cholecystectomy may be safely performed in patients with gallbladder duplication. Preoperative recognition with appropriate imaging modalities, including ultrasound and MRCP may avoid surgical complications. In cases where the anomaly is detected intraoperatively during cholecystectomy, meticulous dissection and intraoperative cholangiography will avoid iatrogenic injuries and lead to successful outcomes.

English

Gallbladder duplication is a rare congenital malformation, occurring in about one per 3000 - 4000 births.1 Presence of a double gallbladder was first reported in 31 BC by Pliny.2 Since then, 213 cases of true duplication of gallbladder have been described. Anatomic variation of duplication of gallbladder is classified according to Boyden’s classification¹ into two groups – 1) Vesica fella divisa and 2) Vesica fella duplex (again divided into Y type and H type).

Complete gallbladder duplication – Seventh report in world literature

Gallbladder duplication results from a rare abnormality of embriogenesis1 and is twice as common in women as in men2 .The signs and symptoms of double gallbladder cholecystitis are the same as those of single gallbladder cholecystitis: strong pain in the epigastric region and right hypochondrium, which may irradiate to the back and be accompanied by nausea and/or vomiting, Murphy positive sign, and pain on palpation of these regions; plastron may also be present3 . For this reason, many cases are still diagnosed intraoperatively, making surgery difficult and increasing the possibility of biliary tract injury. We report the case of a female patient with epigastric and dorsal pain for 4 days, which worsened with the ingestion of salty and fatty foods and was accompanied by nausea and vomiting. Physical examination showed a positive Murphy sign. A complete abdominal ultrasound examination showed gallbladder duplication, both lithiasic. Magnetic resonance cholangiography confirmed the duplication of the gallbladder and cystic ducts, with a single main biliary tract and acute lithiasic cholecystitis in both gallbladders. A laparoscopic cholecystectomy of both vesicles was performed without complications, and the patient was discharged 3 days after the procedure.