Avoiding the Falciform Ligament Sign during the Intraoperative Cholangiogram

Abstract

We have observed that the falciform ligament can appear prominently as a vertical lucent artifact making cholangiography difficult during laparoscopic cholecystectomy. Our suspicion is that this is due to the pneumoperitoneum, and once the pneumoperitoneum is released, this artifact disappears. We have presented images displaying this phenomenon that we feel would be useful for general surgeons operating on the gallbladder.