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symptoms. Diagnosis of CD was confirmed by histology. Cholangiocarcinoma was present in one patient (2,6%). Conclusion: IHBC in Argentina are more common in females with left hemiliver involvement. Surgical resection is the best curative option in unilateral disease with long term survival free of symptoms and complications. In cases of bilateral disease types 5 or 4A cysts, hepaticojejunostomy could be an altermative treatment before indication of liver transplantation.

Background: Laparoscopic Cholecystectomy (LC) is the gold standard surgical procedure for removal of gall bladder. However in difficult situations, it is customary to convert it to an open procedure. Methods: A prospective data analysis was done for 208 consecutive cases of LC performed in a surgical unit at National Hospital of Sri Lanka from September 2012 to January 2017. Results: Out of 208 patients, 152 were women (73.1%) with a mean age of 47.6 years (range 21-79). Biliary colic (37.5%), chronic cholecystitis (31.6%) and acute cholecystitis (10.1%) were the commonest indications for LC. Eighteen patients who had CBD stones underwent CBD exploration simultaneously. Among 208 cases 19 had empyema, 8 had mucocoele and 1 had choledochoduodenal fistula. In 31 difficult cases retrograde cholecystectomy was performed and out of them 9 patients underwent subtotal cholecystectomy. All cases were successfully managed laparoscopically with zero conversion rate. Bile spillage was the commonest complication (21.4%) and average postoperative hospital stay was 2.9 days. Conclusion: With safe dissection and timely resorting to retrograde cholecystectomy in experienced hands, there seems to be no reason for conversion to open cholecystectomy. Most of the complicated cases can be successfully managed laparoscopically without conversion to open procedure.

Background: Laparoscopic Cholecystectomy (LC) is the gold standard surgical procedure for removal of gall bladder. However in difficult situations, it is customary to convert it to an open procedure. Methods: A prospective data analysis was done for 208 consecutive cases of LC performed in a surgical unit at National Hospital of Sri Lanka from September 2012 to January 2017. Results: Out of 208 patients, 152 were women (73.1%) with a mean age of 47.6 years (range 21-79). Biliary colic (37.5%), chronic cholecystitis (31.6%) and acute cholecystitis (10.1%) were the commonest indications for LC. Eighteen patients who had CBD stones underwent CBD exploration simultaneously. Among 208 cases 19 had empyema, 8 had mucocoele and 1 had choledochoduodenal fistula. In 31 difficult cases retrograde cholecystectomy was performed and out of them 9 patients underwent subtotal cholecystectomy. All cases were successfully managed laparoscopically with zero conversion rate. Bile spillage was the commonest complication (21.4%) and average postoperative hospital stay was 2.9 days. Conclusion: With safe dissection and timely resorting to retrograde cholecystectomy in experienced hands, there seems to be no reason for conversion to open cholecystectomy. Most of the complicated cases can be successfully managed laparoscopically without conversion to open procedure.

Background: Calculi formation after incomplete removal of gallbladder can cause post cholecystectomy syndromes.Diagnosis and management of the remnant gallbladder can be problematic. Once diagnosed ,completion of cholecystectomy indicated. Despite of technical difficulties , laparoscopic approach for removal of the remanant gallbladder is possible. Methods: Here, we present a laparoscopic completion of cholecystectomy for gallbladder remnant in a 34 years old female patient who was operated on for symptomatic cholelithiasis six years ago.The patient admitted for severe right upper quadrant pain. Sonography and magnetic resonance colangiopancreatography revealed gallbladder with multipl stones. Results: Laparoscopic cholecystectomy for remnant gallbladder was performed.Post operative course was uneventful and patient was discharged the day after surgery. Pathology report revealed chronic inflamation of gallbladder remnant which was measuring 45 mm in lenght. Conclusion: Although technically demanding , laparoscopic removal of the remnant gallbladder can be safely performed.