The First Ever Described Transhepatic Gallbladder

Abstract

A transhepatic gallbladder is an exceedingly rare finding that presents unique challenges for the general surgeon who often encounters it unexpectedly. A sonogram will not demonstrate it. A gallbladder that wholly penetrates the right lobe of the liver and is clearly visible on the anterior surface is an enigma. We describe an incidental finding at the time of elective surgery of such a phenomenon. This presented the author with a unique problem - how to remove the entire gallbladder without leaving a hole in the right lobe of the liver through which bowel could herniate. A novel technique was utilized which left a small bridge of cauterized gallbladder fundus wall. This article delves into the embryology of the hepatobiliary system in order to surmise how this could have occurred during development. This transhepatic gallbladder also contained a septum, dividing the gallbladder transversely into unequal parts. We hope that our findings and operative description will assist future surgeons that encounter a similar anatomic problem.