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SAGESThe SAGES Safe Cholecystectomy Program - Strategies for M...This article shows 6 strategies surgeons can employ to adopt a universal culture for safe cholecystectomy and minimize the risk of bile duct injury.Please take care, This is unfortunate and highlights the importance of obtaining a critical view before clipping and taking down any structure. WhatsApp Video 2025-12-16 at 13.10.23.mp4

quote from "Pediatric Surgery (Springer Surgery Atlas)" by Prem Puri, Michael E. Höllwarth - "Fusiform choledochal cyst is usually associated with complicated PBMU as well as debris and/or protein plugs in the common channel. Pancreatic duct anomalies are also often present. IE should be performed up to the distal common bile duct in fusiform cases to confirm that dissection can be performed safely."

quote from "Pediatric Surgery (Springer Surgery Atlas)" by Prem Puri, Michael E. Höllwarth - "In cystic choledochal cyst, the distal common hepatic duct is narrow—sometimes so narrow that it looks blind-ended and cannot be identified specifically. Thus, if mucosectomy is completed up to the pancreatico-biliary junction, it is unlikely that a residual cyst will develop within the pancreas (Fig. 42.5). In contrast, in fusiform choledochal cyst, excision of the distal common hepatic duct is more difficult because the distal common bile duct is still wide at the pancreatico-biliary junction; if it is not excised properly, the likelihood that the distal common bile duct will be left within the pancreas is high."

quote from "Pediatric Surgery (Springer Surgery Atlas)" by Prem Puri, Michael E. Höllwarth - "Surgical problems with cystic choledochal cyst are most often encountered on the proximal side of the pathology, occurring as a result of anatomic variants of the common hepatic duct, uncertainty in relation to the excision level of the common hepatic duct, dilated IHBD, and debris and/or stenosis in the IHBD. In contrast, surgical problems with fusiform choledochal cyst most often arise on the distal side of the malformation and are due to uncertainty in relation to the excision level of the distal choledochus, debris in the common channel, and complicated PBMU." Quote from "Pediatric Surgery (Springer Surgery Atlas)" by Prem Puri, Michael E. Höllwarth - "In comparison with fusiform choledochal cysts, there are usually more adhesions between a cystic choledochal cyst and surrounding vital structures such as the portal vein and hepatic artery, especially in older children. In adolescents and adults, the adhesions are often very dense, and great care is required during cyst excision."