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

Figure 7 Example of intraoperative prediction of difficult gallbladder. A: Moderate pericholecystic adhesions; B: Extensive pericholecystic adhesion. Gallbladder is not visualized in both of these situations predicting difficult dissection. Such findings may suggest severe underlying inflammation with or without the presence of contained gallbladder perforation or cholecystoenteric fistula. The surgeon should be careful during dissection as adjoining adherent viscera, duodenum or colon, might be injured during adhesiolysis.