Agenesis Of The Gall Bladder And Cystic Duct: Laparoscopic Diagnosis

Congenital absence of gall bladder is a very rare but well recognised congenital abnormality, the reported incidence ranging between 0.01 and 0.05%. To our knowledge, this is the 1st case reported from UK that was diagnosed by imaging modalities avoiding laparotomy. Laparoscopic cholecystectomy was attempted on a suspected case of chronic cholecystitis and was found to have congenital absence of gall bladder and cystic duct. The diagnosis was confirmed by CT Scan and ERCP post operatively. Standard investigations for chronic cholecystitis are misleading. Agenesis of gall bladder should be highly suspected whenever the gall bladder is not visualised on ultrasonography or at laparoscopy done on misinterpreted ultrasound. If the gall bladder is not seen at laparoscopy, further procedure should be avoided and agenesis should be confirmed by a combination of imaging modalities namely CT Scan, MRCP, laparoscopic or endoscopic ultrasound, if available. If the gall bladder is not visualised at preoperative ultrasound a combination of above imaging modalities should be used for diagnosis without recourse to laparoscopy / laparotomy. DEPARTMENT WHERE WORK WAS DONE Department of General Surgery West Cumberland Hospital Whitehaven Cumbria CA28 8JG United Kingdom