بعض النصائح أثناء إجراء إستئصال المرارة بالمنظار الجراحي في حالة وجود إلتهاب مزمن

During Laparoscopic cholecystectomy for acute on top of Chronic calcular cholecystitis, proper dissection should be done to achieve the best possible critical view of safety as seen in the video .

The pouching effect of the large stone in the Hartman’s pouch is seen well, the cystic duct is short and obstructed by the impacted stone in the Hartman’s pouch, and the large Hartman’s pouch was sagged towards the right side and lodged in a fossa to the right side of the bile duct.

Dissection was started by dissecting the Hartman’s pouch from the right side to free the Harmann’s pouch to facilitate dissection of the cystic duct and cystic artery to achieve the best possible critical view of safety before clipping and division of the cystic duct and cystic artery, then cholecystectomy has been completed in a standard fashion.

Thanks to Allah The Merciful .