PMC7876732_01
Operative photograph showing the absence of gallbladder under the right lobe of the liver.
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Preliminary laparoscopic exploration showed no evidence of gallbladder under the right lobe of the liver (Fig. 1).
The gallbladder before the puncture.
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The gallbladder was then deflated by a needle insertion using the 5 mm right flank port (Fig. 2), and the purulent fluid inside was sent for bile culture.
The gallbladder extirption is performed in an anterograde way; the gallbladder's bed lies to th left of falciform ligament.
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Since the anatomy was unexpected, we preferred to perform an anterograde dissection of the gallbladder to obtain a better exposition of the hilum (Fig. 3).