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This is a case of a 42 year old male
with a previous history of abdominal pain
for 6 months. He was admitted to the hospital
with nausea but vomiting or fever. An
ultrasound study showed gallstones with
some thickening of the gallbladder wall.
The diagnosis of cholecystitis was made
and the patient was scheduled to undergo
a laparoscopic cholecystectomy. This picture
shows the omentum partially covering the
gallbladder in its normal position.
Due to significant distention of the
gallbladder, a needle is used to drain
some bile so grasper clamps can be applied
for dissection and manipulation.
The Hartmann'a pouch is rectracted laterally
and upward, exposing the triangle of Calot
where the cystic artery can be identified
branching off the right hepatic artery.
A short cystic duct is dissected free
using a "right angle" clamp.
Clips are applied to the
cystic duct away from the common bile
duct.
The cystic duct is transected
using scissors.
Same technique is used with
the cystic artery which is dissected free
using a "right angle" clamp
and will be divided between clips.
Hook electrocautery is used
to dissect the gallbladder off the liver
bed.
The gallbladder is now free
and will be placed into a Pleatman sac
for retreival.
This picture shows the body
of the gallbladder, that becomes distended
during removal. Caution must be used to
avoid rupture while pulling.

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