Post Laparoscopic cholecystectomy specimen opened to display the typical colour of the mixed gallstones but predominantly cholesterol in content
The image on the left demonstrates a normal intraoperative cholangiogram performed early in the dissection. Subsequent dissecton resulted in hemorrhage and clip placement across the CBD as shown on the ERCP
Acute gangrenous cholecystitis in an 81 y.o. male.
Acute Gangrenous cholecystitis in an 81 y.o.male
Stay sutures have been placed and tied. Two enterotomies have been made and the stapler is inserted into the two enterotomies. The bowel and gallbladder must be carefully positioned to fully utilize the entire length of the stapling device (by pulling the
Excessive traction on the gallbladder infundibulum may “tent up” the common duct, increasing the likelihood that a clip will impinge on the duct and obstruct it.
Retract the fundus of the gallbladder toward the right axilla and the infundibulum laterally to expose Calot’s triangle. Retracting the infundibulum anteriorly or even upward tends to collapse Calot’s triangle and increase the risk of ductal injury.
The monitors,anesthesia machine, and relative position of surgeon and first assistant have been adapted to the diagonal operating table placement.
laparoscopic resection of ovarian dermoid
Giant Common Duct Stones