Miyajima N, Yamakawa T, Varma A, Uno K, Ohtaki S, Kano N
Department of Surgery, Teikyo University Hospital at Mizonokuchi, Kanagawa, Japan.
Surg Endosc. 1995 Jan;9(1):63-6. doi: 10.1007/BF00187889.
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 changes in the gallbladder. No lesions were endoscopically noted in the stomach. CT scan could not demonstrate the anomaly. ERCP revealed a duplication 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 performed successfully in this case. This paper presents this particular case because of double gallbladder's rarity in the literature and to emphasize the importance of preoperative cholangiographic evaluation for double gallbladder. The laparoscopic surgeon is given an idea of the meticulous dissection at the "hepatocystic triangle" due to the various other vascular and other congenital anomalies associated with it. An account of the classification of this congenital abnormality and its various types is also discussed here.
双胆囊是一种罕见的先天性异常，腹腔镜胆囊切除术时遇到这种情况对腹腔镜外科医生来说是一项挑战。一名28岁主诉上腹部疼痛的男性患者在日本东京女子医科大学水之口医院接受评估。实验室检查结果无异常。超声检查显示每个胆囊腔内有一个声影，胆囊无任何炎症改变。胃镜检查未发现胃内病变。CT扫描未能显示该异常。内镜逆行胰胆管造影（ERCP）显示胆囊影像重复，每个囊腔内有结石，且来自两个胆囊的两条胆囊管汇合后汇入胆总管。该病例成功实施了腹腔镜胆囊切除术。本文报告这一特殊病例是因为双胆囊在文献中较为罕见，并强调术前胆管造影评估对双胆囊的重要性。由于与“肝胆囊三角”相关的各种其他血管和先天性异常，本文让腹腔镜外科医生了解了该区域细致的解剖结构。本文还讨论了这种先天性异常的分类及其各种类型。
