Clinical Report: Laparoscopic Approach to Managing Double Gallbladder Anomaly

Background

Double gallbladder anomalies are rare congenital conditions with an incidence of approximately 1 in 4,000. These anomalies often present challenges during laparoscopic cholecystectomy due to associated cystic duct variations, which can increase the risk of biliary injury. Accurate preoperative imaging is essential for surgical planning, but discrepancies between imaging and intraoperative findings can occur.

Data Highlights

No numerical data available in the article.

Key Findings

• The patient was diagnosed with gallbladder stones and acute cholecystitis complicated by a double gallbladder malformation.
• Preoperative MRI/MRCP suggested a Harlaftis type I Y-variant, which did not match intraoperative findings.
• Intraoperative cholangiography revealed each gallbladder drained via its own cystic duct into the common hepatic duct.
• The malformation was reclassified as an H-type double gallbladder (Harlaftis Type II) with an abnormally low cystic duct confluence.
• Laparoscopic double cholecystectomy was successfully performed under IOC guidance.

Clinical Implications

Surgeons should be aware that preoperative imaging may not accurately depict complex biliary anatomy. The use of intraoperative cholangiography is crucial when discrepancies arise during surgery.

Conclusion

This case underscores the necessity of real-time intraoperative verification of biliary anatomy in patients with congenital anomalies to avoid misdiagnosis and complications during laparoscopic cholecystectomy.

Related Resources & Content

1. Surgical Endoscopy, 2022 -- Laparoscopic Cholecystectomy with Lumen Guidance for Challenging Gallbladder Cases
2. Frontiers in Medicine, 2026 -- Double gallbladder malformation with duodenal ulcer stricture leading to common bile duct dilation: a case report
3. Identification of Risks and Surgical Adjustments Decrease the Rate of Bile Leakage After Laparoscopic Cholecystectomy: A Study of 5,675 Cases
4. SAGES guidelines for the use of intraoperative imaging of the common bile duct | Surgical Endoscopy | Springer Nature Link
5. Frontiers in Surgery — Three-port laparoscopic cholecystectomy with common bile duct exploration in situs inverse totalis: a case report and literature review
6. Epidemiology and preoperative imaging of double gallbladder anomalies
7. SAGES guidelines for the use of intraoperative imaging of the common bile duct | Surgical Endoscopy | Springer Nature Link
8. https://academic.oup.com/bjsopen/article/9/4/zraf076/8221344