Repeat Cholecystectomy. A Mummified Gallbladder was the Clue to Diagnose Duplicate Gallbladder: A Case Report and Review of Literature

Abstract

Mohie El-Din Mostafa Madany, Ahmed Zakaria, Ali Hussein Abdelaal, Hossameldin Ahmed, Mostafa Amer Bakr, Mohamed Elsaid and Mansor Mohammed Kabbash

Background: Gallbladder duplication is a rare congenital anomaly and a rare cause of post cholecystectomy syndrome.

Methods: We reported a case of missed duplicate gallbladder and performed a review of literature on repeat cholecystectomy Additionally, a systematic review and meta-analysis was performed on the same topic. A database search was performed in PubMed followed by screening according to selection criteria which includes case reports that mentioned repeat cholecystectomy. We excluded all reviews, letters or abstract only articles. JBI critical appraisal tool was used to assess the quality of the included studies.

Results: A 34-year-old, male patient with a history of open cholecystectomy 2 years and 7 months ago, presented with recurrent episodes of severe right hypochondrial colicky pain radiating to the right shoulder. After appropriate history taking, physical examination, revision of the patient’s profile recorded in our database and lastly the mummified gall bladder kept with the patient’s mother, we decided to perform an abdominal ultrasound followed by MRCP to finally conclude intraoperatively that this is a case of duplicate gall bladder.

The systematic review included 20 articles after screening of 238 articles according to our selection criteria. The risk of bias was assessed in the included studies of which 18 studies got good score while only two got fair.

Conclusion: We conclude that we should include duplicate gall bladder as one of the causes of the post cholecystectomy syndrome. Moreover, it highlights that duplicate GB can be missed preoperatively, and operatively even with a senior experienced consultant.

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