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Variations in the Morphology of Gallbladder: A Cadaveric Study with Emphasis on Surgical Implications

Umarani S. , S. Umarani1 , R. Sivaraj2 , V. Anandhi3 , V. Muniyappan4

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Indian Journal of Anatomy 7(3):p 318-322, May-June 2018. | DOI: http://dx.doi.org/10.21088/ija.2320.0022.7318.17

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Abstract

Introduction: Gall bladder is flask shaped and usually lies attached to the inferior surface of the right lobe of the liver by connective tissue. It lies in a shallow fossa in the liver parenchyma covered by peritoneum continued from the liver surface. Cholecystectomy is the single most common intra abdominal operative procedure and it is estimated that about 450,000 cholecystectomies were performed annually. Murphy’s sign is elicitation of tenderness where the right lateral plane touches the 9th costal cartilage and the fundus of the gall bladder usually felt at this level. Hence the present study aims to find out the variations in the position of fundus of gall bladder. Methods: 87 liver specimens were made use for the study. The relationship of the fundus of the gall bladder to the inferior margin of the liver, congenital anomalies and peritoneal relations of the gall bladder was studied. Results: The relationship of the fundus of the gall bladder to the inferior margin of the liver had been classified into supramarginal, marginal, inframarginal and their percentages are 28.69%, 20.33% & 33.89% respectively. The folded fundus of the gall bladder was seen in 5 of 57 specimens. Congenital absence of gall bladder was observed in two liver specimens forming 1.75% of 57 specimens. Section of the liver was made to see the presence of intrahepatic gall bladder there was no gall bladder. Bits of liver tissue were sent for histopathological study and the tissue showed biliary cirrhosis. Conclusion: The occurrence of congenital anomalies and anatomical variations of gall bladder are not common but can be of clinical importance. The growing importance of such variations, lie not only from the point of biliary disease but also with respect to the various invasive techniques in the diagnosis and treatment of gall bladder.

 

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DOI: http://dx.doi.org/10.21088/ija.2320.0022.7318.17

Keywords

Gall Bladder; Cholecystectomy

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