Abstract Gall bladder duplication is a rare congenital anomaly of the biliary system, with an estimated incidence of approximately 1 in 4000–5000 individuals. Although often asymptomatic, it may present with biliary pathology and pose diagnostic and therapeutic challenges. Accurate pre-operative identification is essential to prevent bile duct injury and ensure complete surgical management. Discordant pathology between duplicated gall bladders – such as mucocele in one and cholecystitis in the other – is exceedingly uncommon, with only two similar cases reported in the literature. A 56-year-old male presented with intermittent right hypochondrial pain for 1 month and fever for 3 days. Ultrasonography followed by magnetic resonance cholangiopancreatography (MRCP) revealed a Type II duplicated gall bladder. Imaging showed acute on chronic cholecystitis in one gall bladder and mucocele in the other, indicating discordant pathology. The patient underwent an early laparoscopic cholecystectomy on the day of admission. Due to inflammation in Calot’s triangle, a modified fundus-first approach was used, with division of the gall bladder body above the infundibulum and retrograde identification of both cystic ducts. Both gall bladders were removed safely. The post-operative course was uneventful, and the patient was discharged on post-operative day 3. Duplicated gall bladder is an uncommon anomaly that can complicate surgical management. MRCP is valuable for pre-operative anatomical delineation. In difficult anatomy, a modified fundus-first approach can facilitate safe dissection, and laparoscopic cholecystectomy remains effective.
Sai et al. (Thu,) studied this question.
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