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Fig. 4 | Surgical Case Reports

Fig. 4

From: Intracholecystic papillary neoplasm associated with invasive carcinoma of the remnant gallbladder after subtotal cholecystectomy: a case report

Fig. 4

Intraoperative findings. a A soft mass without evidence of extramural invasion was palpable at the remnant gallbladder (arrow). During lymph node dissection around the hepatic portal region, hepatic and duodenal side bile duct where the cystic duct diverged was taped (yellow tapes). b Using these tapes, approximately 20 mm of the cystic duct located behind the bile duct could be safely exposed. The cystic duct was ligated (arrow) and cut, and the cystic ductal margin was negative on frozen section. c Remnant cholecystectomy with remnant gallbladder bed resection was performed. The right branch of the portal vein was exposed (arrow). d Postoperative status after remnant cholecystectomy, remnant gallbladder bed resection, and regional lymph node dissection. The arrow indicates the common hepatic artery. The right and left hepatic arteries were taped (red tapes). The upper duodenal arteries and the right gastric artery were preserved (arrowheads)

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