13 weeks ago we took this patient for lap chole 2 weeks after the onset of an attack of acute cholecystitis with failure of conservative management as you can see in this image
we couldn’t do the procedure because of tough fibrous adhesions with edema and absence of planes
we kept the cholecystostomy tube for all that period and bile never came out but only clear fluid
today we removed the tube and did the operation
a large stone was completely impacted in the Hartman’s pouch.
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