PMC7306521_01
Ultrasonography findings showing two separate gallbladders (Gallbladder A and Gallbladder B) in fossa area.
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Both gallbladders (A and B) were distended, with a thickened wall and a gallstone impacted in the infundibulum in the first gallbladder and a fundic gallstone in the second one (Fig. 1).
(a) Computed tomography scan showing lithiasic cholecystitis complicated by abscess in segment VI of the liver. (b) The sagittal 2D reconstruction displaying two gallbladders (A and B) with a common peritoneal coat.
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An abdominal Computed Tomography was done, confirming the cholecystitis diagnosis and showing also a wall perforation of one of gallbladders with pericholecystic abscess (Fig. 2).
Magnetic resonance cholangiography: (a) Gallbladder duplication, each with one gallstone and one separately cystic duct. (b) Volume rendering reconstruction showing that these two gallbladders are drained by a common cystic duct (CCD) into a common bile duct (CBD).
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Furthermore, only one cystic artery was detected (Fig. 3).
Intraoperative cholangiogram showing that each gallbladder had an independent cystic duct (CD GA: cystic duct of gallbladder A, CD GB : cystic duct of gallbladder B) that joined in a common cystic duct (CCD) before entering into the common bile duct (CBD).
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This cholangiogram confirmed the presence of a single common cystic duct opening in the common bile duct with retrograde opacification of a separate cystic duct of the second gallbladder (B) (Fig. 4).
The operative piece of cholecystectomy showing two independent gallbladder in a common peritoneal coat and each with separate infundibulum.
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After ligature of the two separate cystic ducts a cholecystectomy with complete resection of both gallbladders was done without incident (Fig. 5).