ISLAMABAD: The case of a unique surgical operation on a patient with two gallbladders, recently carried out by a surgeon in the capital, has been sent to the College of Physicians and Surgeons Pakistan (CPSP) for publication in its journal.

The unique procedure, which was performed through non-invasive means, was one of the first of its kind to be performed in Pakistan.

The surgery was performed on Jan 5 by Dr Rizwan Aziz, a surgeon at the Dr Akbar Niazi Teaching Hospital in Bhara Kahu, who has only recently arrived from the UK.

Insiders told Dawn that the rare anomaly was detected during routine gallbladder surgery on a 50-year-old female patient. When doctors dissected the patient, they were faced with two gallbladders along with two separate draining ducts, entering a common bile pipe.

According to the doctor, although it took time to delineate this anatomy without any damage to the main draining channel, a literature review by the medical team revealed that this procedure had only been performed 25 times around the world. Of these, 21 operations were open surgery while only four had been carried out laproscopically.

Doctor says organ was removed laproscopically, a method only attempted four times in history

Laparoscopic surgery to remove the gallbladder involves the surgeon making a few small incisions on the right side of the patient’s abdomen. They then use one incision to insert a laparoscope – a thin tube with a camera on one end – which displays the gallbladder on a screen and the organ is removed without opening up the patient. This kind of procedure reduces the chances of infection and patients are said to recover faster than the recovery time for open surgeries.

Dr Rizwan Aziz told Dawn that in rare cases, people can be born with two gallbladders.

“In such cases, one gallbladder usually does not work or, if both gallbladders are functional, the opening of one remains very narrow, which increases chances of infection and the development of stones,” he said.

“This was the case with the female patient we treated as there was an infection in one gallbladder while stones had developed in the other one. It was a risky operation as we had to locate the bile duct and see where it was heading. A routine laproscopy usually takes around 45 minutes, but this one took around three hours,” he said.

When asked that why one gallbladder could not be left in the body, he said that it was not possible to remove only one gallbladder.

“In such cases, both gallbladders have to be removed to avoid chances of infection. Moreover, we wanted to discharge her the day after the surgery but she developed an infection, due to which we decided to retain her for another day.”

Dr Aziz said they had obtained the patient’s consent to use her treatment as a case study, which would be published in the CPSP journal. However, he said, the patient’s identity would not be revealed.

Published in Dawn, January 20th, 2022