PMC6849067_01
Intraoperative cholangiogram during index cholecystectomy.. Contrast demonstrates a normal common bile duct and intrahepatic ducts. An additional cystic structure (arrow) contiguous with the common bile duct can be seen.
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Review of her prior records showed that there was no aberrant anatomy noted during her initial operation, and that a cholangiogram was completed with no clear abnormalities identified by the surgeon at the time (Fig. 1).
MRCP performed before the second cholecystectomy.. A gallbladder-like structure in the gallbladder fossa demonstrates flow through an apparent cystic duct. Signal void from the prior cholecystectomy clips can be seen at the superolateral aspect of the duplicate gallbladder (arrow).
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This demonstrated the prior surgical clips, as well as a cystic structure in the gallbladder fossa contiguous with a normal-appearing common bile duct through an apparent cystic duct (Fig. 2).
Intraoperative laparoscopic image from the second cholecystectomy.. The duplicate gallbladder is splayed laterally (arrow). Surgical clips from the prior cholecystectomy are noted in the right side of the image (arrowhead). Dissection confirmed a duplicate gallbladder complete with its own cystic artery and duct.
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On dissection of the prior gallbladder fossa, clips from the prior cholecystectomy were identified along with the anomalous biliary structure inferior and lateral to the noted clips (Fig. 3), which appeared to be a diminutive gallbladder with an isolated cystic duct and artery.
Duplicate gallbladder post-resection.. The duplicate gallbladder was resected in its entirety intact with the surgical clips denoting the origin of the duplicated cystic artery and duct.
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The duplicate gallbladder was resected without complication after which external and internal examination demonstrated an intact organ with a duct (Fig. 4).