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

Author(s): Mourad Halfaoui, Fahad Aurif, Abdullah Salman Dalol, Murad Alahmad, Fathimathul Zumara Anwar, Tamer Abdelhafez Elbakry

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

Introduction: Duplication of the gall bladder is very rare. Due to the unusual anatomy, laparoscopic cholecystectomy can be challenging.

Case Report: Two routine cases of symptomatic gallstones presented to the clinic for elective laparoscopic cholecystectomy in 1 week, the first was a 37-year-old male, and the other was a 35-year-old female patient. Ultrasound of the abdomen in the male patient showed a partially distended gall bladder with multiple stones impacted in the neck, focal wall thickening in the fundal region with surrounding collaterals, and diffuse bilobar periportal thickening. An MRCP revealed an extraluminal gall bladder stone superoanterior to neck region narrow thin cleft of fluid around it, representing congenital true or acquired pseudo diverticulum Ultrasound of the female patient revealed a folded gall bladder with multiple stones and a normal CBD. Laparoscopic cholecystectomy was performed successfully in both patients.

Discussion: In the male patient inspection of the gall bladder revealed a diverticulum at the region of the Hartman, the specimen had a single artery and a single cystic duct, the wall of the specimen was thick containing a large stone whilst the diverticulum was thin-walled and had no stones. The female patient inspection revealed duplicated gall bladder with two fundi, each containing stones, a common Hartman’s pouch, and a single cystic duct and single artery.

Conclusion: Double gall bladder is a very rare congenital abnormality. It is prudent to pay extensive attention to the ductal and vascular anatomy. Laparoscopic cholecystectomy with intraoperative Cholangiogram is preferred in difficult cases.

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    Yasuo Iwasaki

  • Division of Neurology, Department of Internal Medicine
    Toho University School of Medicine
    Ota-ku, Tokyo, Japan

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