Abstract: [Abstract] Objective To investigate the clinical skills of difficult laparoscopic cholecystectomy(LC) and improve the safety of LC in the treatment of difficult gallbladder stone disease. Methods The clinical data of 127 cases of difficult LC in the Department of Hepatobiliary Surgery,Xiaogan Hospital affiliated to Wuhan University of Science and Technology from March 2018 to March 2021 were retrospectively analyzed.109 patients were completed LC successfully by rouviere sulcus guided dissociation method,among which 6 patients with vascular or cystic duct inflow variation used anterior-inverse combination method.13 patients with “frozen structure” in gallbladder triangle underwent laparoscopic subtotal cholecystectomy;5 patients were converted to open surgery.Results The mean operation time was (85.2±18.7)min,and the mean blood loss was (73.3±15.7)ml.There were no bile duct or portal vein injuries and 6 cases of biliary leakage were cured after 9 to 15 days of adequate drainage.The follow-up period ranged from 6 to 12 months,and there were no Long-term surgical complications.Conclusion Under the condition of abundant LC technology, LC is safe and feasible to treat complex gallstones.

Key words: laparoscopic cholecystectomy, gallbladder triangle, Rouviere sulcus