The Absent Adult Gallbladder

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Abstract
The purpose of this report is to bring attention again to the rare condition of congenital absence of the adult gndlbladder without other congenital billiard tract abnormality, to present the only case recorded as such at the Royal Melbourne Hospital, to state the conditions that must be satisfied before the operative diagnosis is made, and to point out the need for permanent drainage of the common bile duct, which at the stage at which the abnormality is diagnosed is abnormal.Summary: 1. A further case of congenital absence of the adult gallbladder is reported.2. Before it is reasonable to make a diagnosis of congenital absence of the gallbladder at operation, one must have dissected the extra‐hepatic ductal system, palpated binianually the lesser omentum, falciform ligament and liver, probed suspicious areas of the liver (“sounding” for stone) and performed an operative cholangiogram, this latter being the most important, and indeed an essential, manceuvre.3. In young patients a drainage procedure, preferably biliary fenestration, is necessary to prevent continued symptoms and recurrent stone formation. In the older, more frailpatient, permanent T‐tube drainage may suffice.

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