PMC3015248_01
Preoperative ERCP demonstrating double gallbladder with stones. (See arrows.)
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F1
Computed tomography (CT) and endoscopic retrograde cholangiopancreatogram (ERCP) confirmed the presence of an accessory, partially intrahepatic gallbladder, which also contained stones (Figure 1).
Intraoperative cholangiogram performed via the accessory gallbladder. (Upper arrow shows the left hepatic duct. Lower arrow points at the accessory gallbladder.)
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F2
Since the accessory gallbladder did not have an identified cystic duct on ERCP, the laparoscopic procedure started with a double cholangiogram through the cystic duct of the normal gallbladder and the accessory gallbladder ((Figure 2).
Completion T-tube cholangiogram showing continuity of the biliary tree. (Upper arrow shows the left hepatic duct. Lower arrow points at the pancreatic duct.)
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F3
Completion cholangiogram revealed several small stones in the distal common bile duct, which was then explored (Figure 3).