Bilobed Gallbladder Presenting as a Double Hartmann’s Pouch: A Rare Anatomical Variant During Laparoscopic Cholecystectomy
Himanshu Agrawal
Department of General Surgery, UCMS and GTB Hospital, Delhi, India.
Sanyam Khurana *
Department of General Surgery, UCMS and GTB Hospital, Delhi, India.
Shailender Maurya
Department of General Surgery, UCMS and GTB Hospital, Delhi, India.
Garima Dwivedi
Department of General Surgery, UCMS and GTB Hospital, Delhi, India.
Isha Jain
Department of General Surgery, UCMS and GTB Hospital, Delhi, India.
*Author to whom correspondence should be addressed.
Abstract
Anatomical variations of the gallbladder may increase the risk of biliary injury during cholecystectomy if unrecognized. We report a rare intraoperative finding of a bilobed gallbladder presenting as a double Hartmann’s pouch in a patient undergoing laparoscopic cholecystectomy for symptomatic cholelithiasis. Preoperative ultrasonography did not reveal this anomaly. Intraoperatively, two prominent pouch-like outpouchings were noted at the gallbladder neck. Careful dissection of Calot’s triangle enabled clear delineation of anatomy, revealing a single cystic duct and artery. The critical view of safety was achieved prior to division of structures. The procedure was completed laparoscopically without complications. This case highlights the importance of recognizing atypical gallbladder morphology and adhering to safe surgical principles to prevent bile duct injury.
Keywords: Gallbladder abnormalities, laparoscopic cholecystectomy, biliary tract, cholelithiasis, bile ducts