This video was part of the Video Loop during the SAGES 2020 VirtualMeeting. Topic: Biliary Management of the Difficult Gallbladder. Suhail Zeineddin, MD, Paul Anthony, R Del Prado, MD, FACS (Maricopa Integrated Health System). Laparoscopic cholecystectomy is one of the most common procedures in general surgery. The critical view of safety is an important step for a successful operation. However, obtaining this view may not be straight-forward at all times and conversion to open is sometimes thought to be the only way. In this video, we share our experience with port placement to increase visualization, techniques to improve difficult gallbladder retraction, an approach to a thick cystic duct, the top-down variation, the decision to perform a subtotal cholecystectomy, and the extreme situation where we converted to open.
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