Treatment
General anaesthesia did not pose any complications. A standard
laparoscopic port placement was performed starting with a modified
Hasson port insertion with a single 11mm infra- umbilical port and 11mm
epigastric and two 5mm lateral ports. The gallbladder was found to be
contracted and inflamed with dense adhesions. Dissection of Calot’s
triangle was difficult due inflammation and extensive friable bleeding
tissues. Strasberg’s critical view of safety was achieved [8], and
the cystic artery and duct were each secured with two haemolocks.
Haemostasis was secured with diathermy and a small amount of FIBRILLARTM
applied to the gallbladder fossa in the liver. A 21Fr Wallace drain was
inserted at the gallbladder fossa to assess for blood loss or early bile
leak. The 11mm ports were closed with a No.1 J Polyglactin 910 (VICRYL®)
suture. Tissue strength appeared to be satisfactory. The patient was
monitored in HDU overnight and stepped down to the ward. The patient
remained stable and clinically well and was therefore discharged on
postoperative day two. The drain remained in situ for a further week
post discharge as a precaution.