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| Double cholecystectomy in case of accessory gallbladder: Not as easy as two cholecystectomies |
| Benjamin Darnis a , ∗, Kayvan Mohkam a , b , François Cauchy c , Jean-Yves Mabrut a , b |
a Department of General Surgery and Liver Transplantation, Hospices Civils de Lyon, Croix-Rousse University Hospital, Lyon, France
b Ecole Doctorale EDISS 205, Université Lyon 1, EMR 3738, Lyon, France
c HPB Surgery and Liver Transplantation Unit, Beaujon Hospital, Clichy, France
* Corresponding author.
E-mail address: benjamin.darnis@chu-lyon.fr (B. Darnis). |
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Abstract Accessory gallbladders (AG) are rare and their management are usually challenging. These variations are related with an abnormal division of the bile ducts precursors between the 5th and the 12th week of pregnancy. Harlaftis et al. [1] proposed an anatomical classification of these variations based on the embryologic abnormalities described. In type 1 both gallbladders are connected to the common bile duct at the same location. In type 2 the AG can reach either the common bile duct (ductular type) or an intrahepatic biliary duct (trabecular type). In type 3, three gallbladders are present. A fourth type was recently added to the Harlaftis classification [2]. In this type, the AG is not connected to the biliary tree or the gut. The histologic structure of an AG is the same as a normal gallbladder with the presence of a muscular layer in the gallbladder wall, whereas this layer is not present in the upper part of the main bile duct. The two main lesions that mimic an AG are a hepatic cyst near the gallbladder and a Todani II bile duct cyst (or bile duct diverticulum). In this last case a muscular layer is not found, which is the only characteristic that differentiate it from an AG [2]. The prevalence of AG seems to be higher in eastern countries [2–5]. The oncological risk of such biliary malformation seems to be low [2, 4]. We herein presented our experience of the AG management in 4 cases.
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2019, Vol. 18 
