By Henry Buchwald, MD, PhD
During a routine laparoscopic cholecystectomy, the surgeon finds the bile ductal anatomy confusing. He continues to dissect for more than two hours and makes a decision on the ductal structure to divide, which may be correct or catastrophic.
Why did he not open the abdomen beforehand via a restricted subcostal incision to avoid possibly making a poor decision and probably save time? Was it because he knew that his open surgery skills were limited and based on