The difficult laparoscopic cholecystectomy: a bailout strategy

Laparoscopic cholecystectomy is one of the most frequent surgeries today. Given the procedure’s extensive adoption by surgeons across all skill levels, from novices to experts, it becomes imperative to develop guidelines to ensure its safety for patients. Since complexi-ty of surgeries differ in each person, ranging from simple to intricate cases involving a frozen Calot’s triangle, it is extremely important to perform laparoscopic surgery carefully to avert any potential harm. Given its global prevalence, even a 0.1 % complication rate translates to a significant figure. Therefore, practicing safe cholecystectomy is advocated strongly. This review presents modern approaches to laparoscopic cholecystectomy in difficult cases — bailout surgery — to prevent damage to the bile ducts and vessels. In particular, the features of subtotal cholecystectomy, fundus-first cholecystectomy, and infundibular dissection are considered.