EXPERIENCE WITH LAPAROSCOPIC DOUBLE GALLBLADDER REMOVAL

Double gallbladder is a rare congenital anomaly and an encounter with it while performing cholecystectomy laparoscopically is a challenge to the laparoscopic surgeon. A 28-year-old man complaining of epigastric pain was evaluated at Teikyo University Hospital, Mizonokuchi, Japan. There were no abnormal laboratory findings. Ultrasonography revealed an acoustic shadow in each compartment without any inflammatory change s in the gallbladder. No lesions were endoscopically noted in the stom ach. CT scan could not demonstrate the anomaly. ERCP revealed a duplic ation of the gallbladder shadow with a stone in each vesicle and also the confluence of two cystic ducts from both the gallbladders draining into the common bile duct (CBD). Laparoscopic cholecystectomy was per formed successfully in this case. This paper presents this particular case because of double gallbladder's rarity in the literature and to e mphasize the importance of preoperative cholangiographic evaluation fo r double gallbladder. The laparoscopic surgeon is given an idea of the meticulous dissection at the ''hepatocystic triangle'' due to the var ious other vascular and other congenital anomalies associated with it. An account of the classification of this congenital abnormality and i ts various types is also discussed here.