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Laparoscopic cholecystectomy is guided by working knowledge of bilio-vascular anomalies to prevent common bile duct injuries and bleeding during surgery. Less importance is given to the dissection of the gall bladder from the gall bladder bed where the middle hepatic vein or its large branch can be encountered. The lack of awareness of this presence can result in uncontrolled bleeding and result in significant morbidity or mortality in a seemingly uneventful procedure. It is important to educate all surgeons performing this procedure about the possibility of encountering this vein in a very simple step of the surgery as we did in our case and be wary of its eminent danger.

An Unspoken Threat Hiding behind the Gall Bladder in Laparoscopic Cholecystectomy - The Middle Hepatic Vein