Difficult laparoscopic cholecystectomy

Subtotal cholecystectomy with remnant cystic duct left open


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.