The patient brought to the operative suite and placed in the supine position.  Preoperatively, the patient received IV antibiotics of Ancef, sequential compression devices and subcutaneous heparin.  The abdomen was prepped and draped in the normal sterile fashion with Betadine solution.  Utilizing a #15 blade scalpel, a transverse infraumbilical incision was created.  Utilizing a Veress needle with anterior traction on the anterior abdominal wall with a towel clamp, the Veress needle was inserted without difficulty.  Hanging water drop test was performed with notable air aspiration through the Veress needle and the saline passed through the Veress needle without difficulty.  The abdomen was then insufflated to 15 mmHg with carbon-dioxide.  Once the abdomen was sufficiently insufflated, a #10 mm bladed trocar was inserted into the abdomen without difficulty.  Video laparoscope was inserted and the above notable findings were identified in the operative findings.  The patient to proceed with laparoscopic cholecystectomy was decided and a subxiphoid port was placed.  A #15 bladed scalpel was used to make a transverse incision in the subxiphoid region within the midline.  The trocar was then inserted into the abdomen under direct visualization with the video laparoscope and seen to go to the right of falciform ligament.  Next, two 5 mm trocars were inserted under direct visualization, one in the midclavicular and one in the anterior midaxillary line.  These were inserted without difficulty.  The liver edge was lifted and revealed a markedly edematous gallbladder with severe omental adhesions encapsulating the gallbladder.  Utilizing Endoshears scissor, a plane was created circumferentially to the dome of the gallbladder to allow assistance and dissection of these dense adhesions.  Next, the omental adhesions adjacent to the infundibulum were taken down and allowed to expose the cystic duct.  A small vessel was seen anterior to the cystic duct and this was clipped two proximally and one distally and noted to be an anomalous arterial branch.  This was transected with Endoshears scissor and visualized the pulsatile branch with two clips securely in place.  Next, the cystic duct was carefully dissected with Maryland dissectors and was visualized clearly both anterior and posteriorly.  Endoclips were placed two proximally and one distally and then the cystic duct was transected with Endoshears scissor.