After the cystic duct has been isolated, it is thoroughly palpated to ascertain that no calculi have been forced into it or the common duct by the application of clamps and that none will be overlooked in the stump of the cystic duct. The size of the cystic duct is carefully noted before the right-angle crushing clamp is applied. If the cystic duct is dilated and if it seems from palpation that the gallbladder contains calculi so small that they could pass through it easily, it is advisable to perform a choledochostomy. Regardless, an operative cholangiogram is performed routinely through the cystic duct after it has been divided (Plate 97, Figure 24). Because it is more difficult to divide the cystic duct between two closely applied right-angle clamps, a curved half-length clamp is placed adjacent to the initial right-angle clamp. The curvature of the half-length clamp makes it ideally suited for directing the scissors downward during the division of the cystic duct (Figure 16). Whenever possible, unless occluded by severe inflammation, the cystic duct and cystic artery are isolated separately to permit individual ligation. Under no circumstances is a right-angle clamp applied to the supposed region of the cystic duct in the hope that both the cystic artery and cystic duct can be included in one mass ligature. It is surprising how much additional cystic duct can often be developed by maintaining traction on the duct as blunt gauze dissection is carried out. After the cholangiogram, the cystic duct is ligated with a transfixing suture (Figure 17) or ligature, being sure not to encroach on the common duct. In general, the free length beyond the tie should approximate the diameter of the duct or vessel.