Presentation
A patient in their 40s with years of recurrent right-upper-abdomen pain, several past attacks of gallstone inflammation, and growing fear of a "big operation".
Investigations
Ultrasound showed a contracted, stone-filled gallbladder with a thick wall. MRCP confirmed a clear bile duct and mapped the scarred anatomy before surgery.
Operative Findings
At surgery the gallbladder was densely adherent to surrounding structures from repeated inflammation — a classic high-risk "difficult gallbladder" where bile-duct injury risk is real.
Surgical Strategy
A critical-view-of-safety technique was used: structures were positively identified before any clip or cut, with a low threshold to convert to open if safety demanded.
The Procedure
Meticulous laparoscopic dissection separated the inflamed gallbladder from the bile duct and achieved a complete key-hole removal — no conversion, no drain.
Outcome
Home the next day, pain-free, back to normal life within a week with three tiny scars.
Follow-up
Reviewed at two weeks — wounds healed, eating normally, no further attacks. Similar cases of difficult, scarred gallbladders are treated by Dr. Avinash Tank at Dwarika Hospital, Ahmedabad — book a consultation for a personalised opinion.
Even a difficult gallbladder can usually be removed safely by key-hole surgery when approached with the right technique and patience.
Super-specialist GI, bariatric & cancer surgeon. SGPGIMS (India's premier GI centre) + advanced training in Japan & South Korea. Read full profile →
Last reviewed: June 2026Have a similar problem?
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