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Page 2 of 5 Ghaderi et al. Mini-invasive Surg 2018;2:13 I http://dx.doi.org/10.20517/2574-1225.2017.52

Type 1: split primordium group

Septate gallbladder Bilobed or V shaped Y shaped
(10.8%) (9.5%) (24.3%)

Type 2: accessory gallbladder group

H or ductular Trabecular
(48.6%) (2.7%)
[7]
Figure 1. Types of gallbladder duplications. Adapted with permission from Harlaftis et al. , Copyright Elsevier (1977)

in 31 BC as the first reported case. There is consensus, however, over the uncommon incidence of this
anomaly in the human population, which remains at 0.02 to 0.03 percent [2,5,6] .

DG is thought to be the result of excessive budding of the hepatic diverticulum during the development
[2]
of the biliary tree. DG and its anatomical variations were initially described in 1926 by Boyden . In 1977,
[7]
Harlaftis et al. categorized duplicated gallbladder anatomy into the split primordium and accessory
gallbladder groups [Figure 1]. In the type 1, or split primordium group, DGs share a common cystic duct,
[8]
and are further distinguished as septated, bilobed, and Y-shaped . The type 2, or accessory gallbladder
group, is classified based on the presence of more than one cystic duct joining the biliary tree with two
[9]
or more distinct gallbladder primordial . In this group, the gallbladder closest to the liver is termed the
accessory gallbladder . It may be positioned under or within the liver, within the gastrohepatic ligament,
[8]
[9]
or within the gallbladder fossa .
With respect to clinical presentation, DGs are not necessarily characterized by a specific set of symptoms [1,6,10] .
Therefore, DG may be discovered preoperatively, during surgery, or during specimen processing .
[3]
Computed tomography (CT) scan, magnetic resonance cholangiopancreatography (MRCP), endoscopic
retrograde cholangiopancreatography (ERCP), and percutaneous transhepatic cholangiography may all
[11]
result in preoperative diagnosis that assists the surgeon in planning and conducting the operation .
[12]
Treatment of DG via laparoscopy has been described on multiple occasions . Removal of all gallbladders
[3,8]
is vital in preventing persistent cholecystitis and future symptomatic gallstones .
CASE REPORT
A 38-year-old male presented to his local emergency department with right upper quadrant (RUQ)
abdominal pain, accompanied by nausea and vomiting. A CT scan showed two gallbladders with separate
cystic ducts entering distinctly into the common bile duct. There was no evidence of cholecystitis. The