Laparoscopic Cholecystectomy for Duplicated Gallbladder

Autor: Saifullah Nizam, Rohit Chahuan, Neeraj Saxena
Rok vydání: 2019
Předmět:
Zdroj: Hellenic Journal of Surgery. 91:169-171
ISSN: 1868-8845
0018-0092
DOI: 10.1007/s13126-019-0529-8
Popis: Acute cholecystitis is gallbladder inflammation presenting with abdominal pain, leucocytosis and a positive Murphy’s sign in the right hypochondrium. Abdominal ultrasound (US) is the investigation of choice for its diagnosis. Duplication of the gallbladder is an unusual anomaly, which can be asymptomatic or present as acute cholecystitis. It cannot be distinguished clinically from usual gallbladder pathology, but can be identified by preoperative imaging studies. Cholecystectomy is performed for the management of duplicated gallbladder when it is symptomatic. We report a rare case of gallbladder duplication in a 50-year-old female, with cholelithiasis in one champer and a free lumen of the other. US examination was suggestive of duplicate gallbladder, and magnetic resonance cholangiopancreatography (MRCP) was indicative of duplication, with separate cystic ducts. The patient underwent laparoscopic cholecystectomy. Intraoperatively the gallbladder appeared to be a single lumen specimen, but two separate gallbladders and cystic ducts were identified post-operatively during fine dissection of the specimen. A high degree of awareness and detailed preoperative investigations are necessary when congenital anomalies are suspected. Intraoperative cholangiography is indicated for accurate detailing of the biliary tree, in order to avoid inadvertent damage to the biliary ductal system during surgery. Real-time intraoperative imaging using indocya-nine green (ICG) can be utilized to avoid injury to the biliary tree by delineating its anatomy during laparoscopic cholecystectomy.
Databáze: OpenAIRE
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