Difficult laparoscopic cholecystectomy

Subtotal cholecystectomy with remnant cystic duct left open

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  • Case Description

    • Standard laparoscopic cholecystectomy procedures follow the classic approach to visualize Calot's triangle. Under certain circumstances, the dissection may be difficult and even dangerous.
    • Utilizing anatomic landmarks such as the Sulcus of Rouvier and the hilar plate, the 'Top-Around approach' may be attempted to safely visualize the cystic duct and artery.
    • In severe circumstances, the decision to change the surgical plan to a subtotal cholecystectomy should be considered as a valid alternative approach.
  • Special Acknowledgement

    • This video was a collaboration project with Dr. Shiva Jayaraman at St. Joseph's Health Centre.