Bilobed Gallbladder: A Rare Anatomical Variation Discovered During Laparoscopic Cholecystectomy

Abstract

A bilobed gallbladder is a rare congenital anomaly with two lobes sharing a single cystic duct, typically diagnosed preoperatively and rarely identified intraoperatively. Only a small number of cases have been documented in medical literature with limited information on associated conditions. A 22-year-old male patient, with a past medical history of cholelithiasis and no prior surgical history, presented with acute right upper quadrant pain and was diagnosed with acute cholecystitis. Initial ultrasound and magnetic resonance cholangiopancreatography imaging showed a distended gallbladder with multiple stones, but the bilobed gallbladder was only discovered during laparoscopic cholecystectomy, with an intraoperative retrospective imaging review confirming the diagnosis. This anatomical variation can complicate surgery, particularly in achieving the critical view of safety. In this case, a dome-down approach was used to complete laparoscopic cholecystectomy without intraoperative or postoperative issues. Early and accurate diagnosis is challenging but crucial for successful management. In this report, we present our surgical approach to managing this patient. This report aims to contribute to the limited literature on bilobed gallbladders.

Keywords: bilobed gallbladder; cholecystectomy; congenital; gallbladder; imaging; intraoperative.

Figure 1. MRCP axial view displaying both lobes of the bilobed gallbladder.

MRCP: Magnetic resonance cholangiopancreatography

Figure 2. Grossly intact bilobed gallbladder measuring 14 x 5.5 x 4 cm, demonstrating a V-shape with a single cystic duct, with the cystic duct indicated by the red arrowhead.