Twelve patients with multiple vavices were found adjacent to the common bile duct during cholecystectomy and exploration of the common blie duct in the presence of stones. Eleven of them were with cirrhosis. The authors recommend that retrograde cholecystecotomy, or partial cholecystestomy with electrical cauterization of the remaining gallbladder mucosa ,or even cholecystostomy be the optimal selection in the presence of a large venous channel in calot’s triangle. Multiple fine-needle puncture of the bile duct can be performed over the vascullar area until bile is aspirated; extracting the choledocholith from a transduodenal sphincterotomy is another selective maneuver; and if bleeding occurs, suturing for hemostasis can be placed on the connective tissue over both sides of the lacerated vessel instead of the wall of varices.
