{
  "abstract": "With the growth of laparoscopy, open cholecystectomies are often reserved for exceedingly inflamed and difficult gallbladders. We present a case of a patient in her 70s with a history of malrotation and omphalocele requiring silo management with recurrent admissions for acute cholecystitis. She had failed a prior laparoscopic converted to open attempt at cholecystectomy. She presented with right upper quadrant abdominal pain and Computed Tomography (CT) showing numerous anomalies. She was taken to the operating room where her liver was mobilised and eviscerated out of the abdomen; gallbladder was truly intrahepatic. Portal structures and intrahepatic gallbladder were confirmed with intraoperative ultrasound. The gallbladder was subsequently removed with external Pringle and direct liver parenchymal dissection. This case demonstrates that a critical understanding of anatomy with thorough analysis of imaging is essential in patients with extensive adhesive disease or altered anatomy, particularly congenital defects.",
  "authors": [
    {
      "affiliations": [
        "General Surgery Residency, Virginia Mason Franciscan Health, Tacoma, Washington, USA"
      ],
      "name": "Deepa Chandhrasekhar"
    },
    {
      "affiliations": [
        "General Surgery Residency, Virginia Mason Franciscan Health, Tacoma, Washington, USA"
      ],
      "name": "Katelyn Anderson"
    },
    {
      "affiliations": [
        "General Surgery Residency, Virginia Mason Franciscan Health, Tacoma, Washington, USA"
      ],
      "name": "Valerie X Du"
    },
    {
      "affiliations": [
        "General Surgery Residency, Virginia Mason Franciscan Health, Tacoma, Washington, USA"
      ],
      "name": "Nicholas Sich"
    }
  ],
  "title": "Open cholecystectomy via liver evisceration with a history of neonatal malrotation and omphalocele",
  "uid": "5e81cd69-352b-580e-b868-48e0c035ba32"
}