Laparoscopic cholecystectomy for a patient with a double gallbladder.

To cite: Ali MS, Attash SM. BMJ Case Rep Published online: [please include Day Month Year] doi:10.1136/ bcr-2013-200986 DESCRIPTION A 43-year-old woman was referred with a 5-day history of epigastric and right upper quadrant pain associated with nausea. The patient had tenderness in the right hypochondrium on the abdominal examination. She had no jaundice. The leucocyte count and liver function tests were normal, ultrasonography of the abdomen revealed a distended, thick wall gallbladder with multiple small gallstones and normal diameter of the common bile duct and normal pancreas. The patient underwent laparoscopic cholecystectomy the next day. Intraoperatively the patient was found to have a double gallbladder with a single cystic duct (figures 1 and 2). The operation was completed in the usual way (video 1) and the histopathological examination of the specimen revealed a double gallbladder with completely separated lumens and a single cystic duct (figure 3), both lumens filled with multiple small stones with features of an acute inflammation in the two bladders. The patient was discharged home 24 h later. Double gallbladder is an unusual congenital biliary anomaly, occurring at the rate of 1/4000. Most cases are asymptomatic and may be missed. However, this anomaly may cause diagnostic and surgical problems in case of cholecystitis. Failure to detect the accessory gallbladder has been