Laparoscopic cholecystectomy with "retraction" of cystic duct: Damage reason for biliary tract

The bile duct injury during cholecystectomy is higher in laparoscopy than in the traditional open technique (0,2-2%) and it is connected to the laparoscopic learning curve, sometimes neglected. Experience has a central role in the correct performance. There are, however, some anatomic conditions which may compromise the operation even when performed by an expert, such as the infundibular retraction of a short cystic duct with the laparoscopic presentation of the bile duct instead of the cystic duct during exposure and detachment. We present a case in which the infundibular retraction of the cystic duct, due to phlogistic phenomena could have deceived the surgeon as the choledoch was found exactly in the position of the cystic duct during detachment of the Calot.