The gallbladder was markedly inflamed and edematous with 2 stones impacted at the neck.
An open mini-lap (2-inch incision) cholecystectomy was done. A laparoscopic cholecystectomy would be difficult to do.
Aspiration of the bile was initially done to decompress the gallbladder and to enable the surgeon to grasp it during dissection.
The gallbladder was transected at the neck to extract the stones impacted at the cystic duct and to facilitate the discernment of the junction of the cystic and common bile duct.