ABSTRACT
The gallbladder bed comprises of a fibrous layer, the ‘cystic plate’ that overlies the liver parenchyma. The space between the gallbladder and the cystic plate is traversed by fibro-areolar tissue, blood vessels and lymphatics. Chronic inflammation renders it fibrotic, resulting in firm adhesions between the gallbladder and the cystic plate. Dissection under such circumstances can result in either perforation of the gallbladder, leading to bile and stone spillage or a breach of the cystic plate with the risk of serious bleeding and/or bile leak.
