Safe laparoscopic cholecystectomy: Adoption of universal culture of safety in cholecystectomy

Table 3 Stopping rules: Identification of “Red flags”[38]

Stopping rules
More than 2 tubular structures entering gallbladder
Unusually large presumed cystic artery (this may be hepatic artery)
Large artery pulsations present behind the presumed cystic duct (this duct may be common hepatic/bile duct)
Medium-large clip fails to occlude ductal lumen (this duct may be hepatic/bile duct)
Large ductal structure that can be traced behind the duodenum (this duct is common bile duct)
Excessive fibrofatty/lymphatic tissue noted around the presumed cystic duct (this may be common hepatic/bile duct)
Bile leak seen with intact gallbladder
Bleeding requiring blood transfusion