Agenesis of gallbladder - our experience and a review of literature

Agenesis of gallbladder is a rare congenital anomaly. Variable diagnostic approaches, perioperative management strategies and postoperative follow up protocols provide a dilemma to its correct diagnosis and management. We hereby present five patients with agenesis of gallbladder encountered in our institution between 1992 to 2008. Four out of five patients had symptoms suggestive of gallstones including upper abdominal pain and acid dyspepsia, which were further substantiated by ultrasound reports showing shrunken contracted gallbladder with calculi. On laparoscopy the gallbladder was absent in all five patients leading to conversion to laparotomy in the initial three patients. With increasing experience, the next two patients were diagnosed conclusively by laparoscopy to have agenesis of gallbladder, without the need for conversion which was further confirmed by post operative imaging studies. Gallbladder agenesis is rarely encountered in clinical practice. With increased experience in laparoscopy, the condition no longer mandates conversion to laparotomy for confirmation of diagnosis. Symptomatic improvement occurs in all patients following surgical intervention.