Summary

We present the case of a 64-year-old woman underwent elective cholecystectomy for stones. Her clinical history included episodes of acute cholecystitis, dyspepsia, obesity. The US described a small gallbladder with thickened and poorly distended walls, as from scelo-atrophic gallbladder. During surgery, we performed a difficult Critical View of Safety because of unexpected small organ size, about 2,5 cm, and its intra-hepatic position. After an antegrade cholecystectomy, a carefully and slow dissection needed to recognize the cystic duct and artery and to complete surgery safely. In this video we want to highlight the difficulties related to an usual simple surgery, the risks of complications and the possible strategies to avoid them.