Today I did a lap chole for a case of Empyema of Gall bladder, male pt. aged 55yrs, of long duration. But while dissecting i was surprised not to find the Cystic duct and artery as in other cases. They were rather (?) replaced by shreds of fatty fibrous tissue which were easily separated and divided by cautery, leaving the GB intact and separated with a solitary calclus in the neck. Had to clip and divide a tiny vessel leading to GB which can`t be termed as cystic artery.
After complete mobilisation of GB with calculus ( it got punctured with pale greenish content coming out of GB during dissection) and removal, GB fossa/liver bed and Callot`s area remained O K without any bleeding, even afterr recheck. So no ligation n division of C artery & duct. GB was not dead or gangrenous but just very thick walled with nearly normal size and contour. Has anybody come across such a situation? My…
