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Ventral Ectopic Gallbladder Over the Hepatic Duct with Dual Cystic Arteries Intraoperative Identification and Strategy
Case description
Ectopic or ventrally displaced gallbladders are rare anatomic variations that present significant operative challenges due to unpredictable relationships with the extrahepatic biliary tree. A long, anteriorly oriented cystic duct joining the common hepatic duct increases the risk of misidentification and injury to the main bile duct, particularly when combined with aberrant arterial supply. Double cystic arteries, as seen in this case, are well-described in anomalous gallbladder positions and require meticulous dissection to prevent hemorrhage and ensure accurate recognition of the hepatocystic triangle. Early awareness of abnormal orientation, gentle separation of peritoneal folds, and the use of intraoperative cholangiography are essential strategies for safely managing these uncommon configurations.
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