Gallbladder Position Anomalies: Clinical Impacts and Management

Gallbladder position anomalies are rare. Normally, the gallbladder is located at the inferior surface of the right lobe of the liver between segments IV and V, covered by the peritoneum, and attached to the liver by its mesentery in the gall bladder fossa. Any position other than this is defined as a gallbladder position anomaly. Gallbladder ectopia variants may include floating, intrahepatic, retroperitoneal, and left-sided gallbladder, among others. According to some literature, floating gallbladder is the most common among these anomalies, occurring in 4.6% of population; however, there is no clear and adequate data on incidence and variants of gallbladder position anomalies. Because of their rare occurrence and lack of specific clinical and imaging features, their possible presence and clinical sequelae are not usually considered in clinical practice. This results in delayed diagnosis and treatment of sequelae, such as in gallbladder volvulus (GBV). Similarly, gallbladder position and associated biliary tree and vascular anomalies should be identified during the preoperative period. Failing to do this may have devastating outcomes. Though clinical impacts and management of gallbladder position anomalies are explained in some literature, they are not well covered by most of the currently available surgical books. To fill this gap, this chapter discusses the embryology, variants, prevalence, clinical impacts, and management of ectopic gallbladder as well as ways to increase the rate of preoperative diagnosis and methods to decrease adverse outcomes and morbidity.