The Difficult Gallbladder: A Safe Approach to a Dangerous Problem

B. Fernando Santos, L. Michael Brunt, Michael J. Pucci

Research output: Contribution to journalReview articlepeer-review

25 Scopus citations


Laparoscopic cholecystectomy is a common surgical procedure, and remains the gold standard for the management of benign gallbladder and biliary disease. While this procedure can be technically straightforward, it can also represent one of the most challenging operations facing surgeons. This dichotomy of a routine operation performed so commonly that poses such a hidden risk of severe complications, such as bile duct injury, must keep surgeons steadfast in the pursuit of safety. The "difficult gallbladder" requires strict adherence to the Culture of Safety in Cholecystectomy, which promotes safety first and assists surgeons in managing or avoiding difficult operative situations. This review will discuss the management of the difficult gallbladder and propose the use of subtotal fenestrating cholecystectomy as a definitive option during this dangerous situation.

Original languageEnglish
Pages (from-to)571-578
Number of pages8
JournalJournal of Laparoendoscopic and Advanced Surgical Techniques
Issue number6
StatePublished - Jun 2017


  • Laparoscopic cholecystectomy
  • difficult gallbladder
  • subtotal fenestrating cholecystectomy


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