import urllib.request
from reportlab.lib.pagesizes import A4
from reportlab.lib import colors
from reportlab.lib.units import cm, mm
from reportlab.lib.styles import getSampleStyleSheet, ParagraphStyle
from reportlab.lib.enums import TA_CENTER, TA_LEFT, TA_JUSTIFY
from reportlab.platypus import (
    SimpleDocTemplate, Paragraph, Spacer, Table, TableStyle,
    HRFlowable, PageBreak, KeepTogether, Image
)
from reportlab.graphics.shapes import (
    Drawing, Rect, String, Line, Polygon, Arrow, Circle,
    RoundedRect, Path, Group
)
from reportlab.graphics import renderPDF
from reportlab.graphics.charts.flowchart import FlowChart
from reportlab.platypus.flowables import Flowable
import io
import os

# ── Download the Strasberg image ──────────────────────────────────────────────
strasberg_url = "https://cdn.orris.care/cdss_images/03bf417319fcd7615ecc2e50fc17fca8410c7432180cd80e3c027def2f1bfcb7.png"
strasberg_path = "/tmp/workspace/lap-chole-pdf/strasberg.png"
if not os.path.exists(strasberg_path):
    urllib.request.urlretrieve(strasberg_url, strasberg_path)

# ── Colour palette ─────────────────────────────────────────────────────────────
C_DARK_BLUE   = colors.HexColor("#1a3a5c")
C_MED_BLUE    = colors.HexColor("#2e6da4")
C_LIGHT_BLUE  = colors.HexColor("#d6eaf8")
C_SKY         = colors.HexColor("#e8f4fc")
C_RED         = colors.HexColor("#c0392b")
C_ORANGE      = colors.HexColor("#e67e22")
C_GREEN       = colors.HexColor("#27ae60")
C_YELLOW      = colors.HexColor("#f39c12")
C_PURPLE      = colors.HexColor("#8e44ad")
C_TEAL        = colors.HexColor("#16a085")
C_LIGHT_GREEN = colors.HexColor("#d5f5e3")
C_LIGHT_RED   = colors.HexColor("#fadbd8")
C_LIGHT_ORANGE= colors.HexColor("#fdebd0")
C_LIGHT_PURPLE= colors.HexColor("#e8daef")
C_GREY        = colors.HexColor("#95a5a6")
C_LIGHT_GREY  = colors.HexColor("#f2f3f4")
C_WHITE       = colors.white
C_BLACK       = colors.black

# ── Document setup ─────────────────────────────────────────────────────────────
OUTPUT = "/tmp/workspace/lap-chole-pdf/Laparoscopic_Cholecystectomy_Complications.pdf"
doc = SimpleDocTemplate(
    OUTPUT, pagesize=A4,
    leftMargin=1.5*cm, rightMargin=1.5*cm,
    topMargin=2*cm, bottomMargin=2*cm,
    title="Complications of Laparoscopic Cholecystectomy",
    author="Medical Reference"
)

styles = getSampleStyleSheet()

# Custom styles
H1 = ParagraphStyle("H1", fontName="Helvetica-Bold", fontSize=22, textColor=C_WHITE,
                    alignment=TA_CENTER, spaceAfter=4)
H2 = ParagraphStyle("H2", fontName="Helvetica-Bold", fontSize=15, textColor=C_WHITE,
                    alignment=TA_CENTER, spaceAfter=4)
H3 = ParagraphStyle("H3", fontName="Helvetica-Bold", fontSize=12, textColor=C_DARK_BLUE,
                    spaceBefore=8, spaceAfter=4)
BODY = ParagraphStyle("BODY", fontName="Helvetica", fontSize=9.5, textColor=C_BLACK,
                      leading=14, spaceAfter=4, alignment=TA_JUSTIFY)
BULLET = ParagraphStyle("BULLET", fontName="Helvetica", fontSize=9, textColor=C_BLACK,
                        leading=13, leftIndent=12, spaceAfter=2,
                        bulletIndent=0, bulletFontName="Helvetica")
CAPTION = ParagraphStyle("CAPTION", fontName="Helvetica-Oblique", fontSize=8,
                         textColor=C_GREY, alignment=TA_CENTER, spaceAfter=6)
SMALL_BOLD = ParagraphStyle("SMALL_BOLD", fontName="Helvetica-Bold", fontSize=8.5,
                             textColor=C_DARK_BLUE, spaceAfter=2)
SOURCE = ParagraphStyle("SOURCE", fontName="Helvetica-Oblique", fontSize=7.5,
                        textColor=C_GREY, spaceAfter=2)

# ── Helper: coloured banner ────────────────────────────────────────────────────
def banner(text, style=H2, bg=C_MED_BLUE, pad=8):
    d = Drawing(doc.width, 32)
    d.add(RoundedRect(0, 0, doc.width, 32, 6, 6, fillColor=bg, strokeColor=bg))
    return [d, Paragraph(text, style)]

def section_header(text, bg=C_MED_BLUE):
    tbl = Table([[Paragraph(text, H3)]], colWidths=[doc.width])
    tbl.setStyle(TableStyle([
        ("BACKGROUND", (0,0), (-1,-1), bg),
        ("TEXTCOLOR", (0,0), (-1,-1), C_WHITE),
        ("TOPPADDING", (0,0), (-1,-1), 6),
        ("BOTTOMPADDING", (0,0), (-1,-1), 6),
        ("LEFTPADDING", (0,0), (-1,-1), 10),
        ("ROUNDEDCORNERS", [6,6,6,6]),
    ]))
    return tbl

# ── Flowable: Flowchart node helper ───────────────────────────────────────────
class FlowBox(Flowable):
    """A coloured rounded-rect box with centred text for flowcharts."""
    def __init__(self, text, width=200, height=30, fill=C_LIGHT_BLUE,
                 stroke=C_MED_BLUE, font_size=9, text_color=C_DARK_BLUE):
        Flowable.__init__(self)
        self.text = text
        self.width = width
        self.height = height
        self.fill = fill
        self.stroke = stroke
        self.font_size = font_size
        self.text_color = text_color

    def draw(self):
        self.canv.setFillColor(self.fill)
        self.canv.setStrokeColor(self.stroke)
        self.canv.setLineWidth(1.2)
        self.canv.roundRect(0, 0, self.width, self.height, 6, fill=1, stroke=1)
        self.canv.setFillColor(self.text_color)
        self.canv.setFont("Helvetica-Bold", self.font_size)
        self.canv.drawCentredString(self.width/2, self.height/2 - self.font_size/3, self.text)


# ══════════════════════════════════════════════════════════════════════════════
#  BUILD CONTENT
# ══════════════════════════════════════════════════════════════════════════════
story = []

# ── PAGE 1 : TITLE ─────────────────────────────────────────────────────────────
# Title banner
title_tbl = Table([[Paragraph("COMPLICATIONS OF", H1),
                    Paragraph("LAPAROSCOPIC CHOLECYSTECTOMY", H1)]],
                  colWidths=[doc.width])
title_bg = Table([[""]], colWidths=[doc.width], rowHeights=[110])
title_bg.setStyle(TableStyle([
    ("BACKGROUND", (0,0), (-1,-1), C_DARK_BLUE),
    ("ROUNDEDCORNERS", [10,10,10,10]),
]))

title_content = Table([
    [Paragraph("COMPLICATIONS OF", ParagraphStyle("TC", fontName="Helvetica-Bold", fontSize=20, textColor=C_WHITE, alignment=TA_CENTER))],
    [Paragraph("LAPAROSCOPIC CHOLECYSTECTOMY", ParagraphStyle("TC2", fontName="Helvetica-Bold", fontSize=24, textColor=colors.HexColor("#f9ca24"), alignment=TA_CENTER))],
    [Paragraph("A Comprehensive Clinical Reference", ParagraphStyle("TC3", fontName="Helvetica-Oblique", fontSize=13, textColor=C_LIGHT_BLUE, alignment=TA_CENTER))],
    [Paragraph("Sources: Maingot's Abdominal Operations · Bailey & Love's Surgery · Greenfield's Surgery · Tintinalli's Emergency Medicine",
               ParagraphStyle("TC4", fontName="Helvetica", fontSize=8, textColor=C_GREY, alignment=TA_CENTER))],
], colWidths=[doc.width])
title_content.setStyle(TableStyle([
    ("BACKGROUND", (0,0), (-1,-1), C_DARK_BLUE),
    ("TOPPADDING", (0,0), (-1,-1), 8),
    ("BOTTOMPADDING", (0,0), (-1,-1), 8),
    ("ROUNDEDCORNERS", [10,10,10,10]),
]))
story.append(title_content)
story.append(Spacer(1, 12))

# ── OVERVIEW BOX ──────────────────────────────────────────────────────────────
overview_data = [
    [Paragraph("<b>OVERVIEW</b>", SMALL_BOLD)],
    [Paragraph(
        "Laparoscopic cholecystectomy (LC) is the gold-standard treatment for symptomatic cholelithiasis. "
        "Complications occur in <b>10-15% of cases</b>. Serious complications fall into two major areas: "
        "<b>access complications</b> and <b>bile duct injuries</b>. "
        "Overall mortality is <b>&lt;0.3%</b>. The incidence of major bile duct injury is "
        "<b>0.4-0.6%</b> (vs 0.1-0.2% for open surgery). "
        "Most serious complications are more common early in the surgeon's learning curve.",
        BODY)],
]
overview_tbl = Table(overview_data, colWidths=[doc.width])
overview_tbl.setStyle(TableStyle([
    ("BACKGROUND", (0,0), (-1,0), C_DARK_BLUE),
    ("BACKGROUND", (0,1), (-1,-1), C_SKY),
    ("TEXTCOLOR", (0,0), (-1,0), C_WHITE),
    ("BOX", (0,0), (-1,-1), 1, C_MED_BLUE),
    ("TOPPADDING", (0,0), (-1,-1), 6),
    ("BOTTOMPADDING", (0,0), (-1,-1), 6),
    ("LEFTPADDING", (0,0), (-1,-1), 10),
    ("ROUNDEDCORNERS", [6,6,6,6]),
]))
story.append(overview_tbl)
story.append(Spacer(1, 14))

# ── MASTER CLASSIFICATION TABLE ───────────────────────────────────────────────
story.append(section_header("CLASSIFICATION OF COMPLICATIONS"))
story.append(Spacer(1, 6))

class_data = [
    [Paragraph("<b>Category</b>", SMALL_BOLD), Paragraph("<b>Specific Complications</b>", SMALL_BOLD), Paragraph("<b>Incidence</b>", SMALL_BOLD)],
    [Paragraph("Biliary", BODY),
     Paragraph("Bile duct injury, bile leak, biliary stricture, retained stones, biliary fistula", BODY),
     Paragraph("BDI: 0.4-0.6%\nBile leak: 1-2%", BODY)],
    [Paragraph("Vascular / Haemorrhagic", BODY),
     Paragraph("Cystic artery bleeding, RHA injury, trocar vessel laceration, abdominal wall haematoma", BODY),
     Paragraph("1-2%", BODY)],
    [Paragraph("Pneumoperitoneum-related", BODY),
     Paragraph("CO2 embolism, vagal reflex, cardiac arrhythmias, hypercarbic acidosis, subcutaneous emphysema, pneumothorax, pneumomediastinum", BODY),
     Paragraph("Rare", BODY)],
    [Paragraph("Trocar / Access", BODY),
     Paragraph("GI tract injury (bowel perforation), GU tract injury, major vessel injury (aorta, IVC, iliac), trocar-site hernia, wound infection", BODY),
     Paragraph("0.1-0.4%", BODY)],
    [Paragraph("Visceral / Miscellaneous", BODY),
     Paragraph("Pancreatitis, splenic injury, retained intraperitoneal stones, intra-abdominal abscess, incisional hernia, biliary cutaneous fistula", BODY),
     Paragraph("Varied", BODY)],
    [Paragraph("Post-operative General", BODY),
     Paragraph("Wound infection, DVT/PE, pulmonary complications, acute MI, urinary retention", BODY),
     Paragraph("Varied", BODY)],
]
class_tbl = Table(class_data, colWidths=[3.5*cm, 10.5*cm, 3*cm])
class_tbl.setStyle(TableStyle([
    ("BACKGROUND", (0,0), (-1,0), C_DARK_BLUE),
    ("TEXTCOLOR", (0,0), (-1,0), C_WHITE),
    ("BACKGROUND", (0,1), (-1,1), C_LIGHT_RED),
    ("BACKGROUND", (0,2), (-1,2), C_LIGHT_ORANGE),
    ("BACKGROUND", (0,3), (-1,3), C_LIGHT_BLUE),
    ("BACKGROUND", (0,4), (-1,4), C_LIGHT_PURPLE),
    ("BACKGROUND", (0,5), (-1,5), C_LIGHT_GREEN),
    ("BACKGROUND", (0,6), (-1,6), C_LIGHT_GREY),
    ("BOX", (0,0), (-1,-1), 1, C_MED_BLUE),
    ("INNERGRID", (0,0), (-1,-1), 0.5, colors.HexColor("#aab7b8")),
    ("TOPPADDING", (0,0), (-1,-1), 5),
    ("BOTTOMPADDING", (0,0), (-1,-1), 5),
    ("LEFTPADDING", (0,0), (-1,-1), 6),
    ("VALIGN", (0,0), (-1,-1), "TOP"),
    ("FONTNAME", (0,0), (-1,0), "Helvetica-Bold"),
]))
story.append(class_tbl)
story.append(Spacer(1, 8))
story.append(Paragraph("Sources: Maingot's Abdominal Operations; Bailey & Love's Surgery 28e; Tintinalli's Emergency Medicine", SOURCE))
story.append(PageBreak())

# ══════════════════════════════════════════════════════════════════════════════
# PAGE 2 : FLOWCHART — INTRAOPERATIVE DECISION (Bile Duct Injury)
# ══════════════════════════════════════════════════════════════════════════════

def draw_flowchart_page1(story):
    story.append(section_header("FLOWCHART 1 — INTRAOPERATIVE RECOGNITION & MANAGEMENT OF BILE DUCT INJURY"))
    story.append(Spacer(1, 8))

    w = doc.width

    def box(text, fill, stroke, width=None, height=34, font_size=9, text_color=C_WHITE, bold=True):
        _w = width or w * 0.7
        _font = "Helvetica-Bold" if bold else "Helvetica"
        tbl = Table([[Paragraph(f"<font name='{_font}' size='{font_size}' color='#{text_color.hexval()[2:]}'>{text}</font>",
                                ParagraphStyle("fb", alignment=TA_CENTER, leading=12))]],
                    colWidths=[_w])
        tbl.setStyle(TableStyle([
            ("BACKGROUND", (0,0), (-1,-1), fill),
            ("BOX", (0,0), (-1,-1), 1.5, stroke),
            ("TOPPADDING", (0,0), (-1,-1), 6),
            ("BOTTOMPADDING", (0,0), (-1,-1), 6),
            ("ROUNDEDCORNERS", [8,8,8,8]),
        ]))
        # Centre
        return Table([[tbl]], colWidths=[w], style=[
            ("ALIGN", (0,0), (-1,-1), "CENTER"),
            ("VALIGN", (0,0), (-1,-1), "MIDDLE"),
        ])

    def arrow():
        d = Drawing(w, 16)
        mid = w/2
        d.add(Line(mid, 16, mid, 0, strokeColor=C_MED_BLUE, strokeWidth=2))
        d.add(Polygon([mid-5, 4, mid+5, 4, mid, 0], fillColor=C_MED_BLUE, strokeColor=C_MED_BLUE))
        return d

    def diamond(text, fill=C_YELLOW, stroke=C_ORANGE, width=None):
        _w = width or w * 0.65
        tbl = Table([[Paragraph(f"<font name='Helvetica-Bold' size='9'>◆  {text}  ◆</font>",
                                ParagraphStyle("dm", alignment=TA_CENTER, leading=12))]],
                    colWidths=[_w])
        tbl.setStyle(TableStyle([
            ("BACKGROUND", (0,0), (-1,-1), fill),
            ("BOX", (0,0), (-1,-1), 1.5, stroke),
            ("TOPPADDING", (0,0), (-1,-1), 7),
            ("BOTTOMPADDING", (0,0), (-1,-1), 7),
            ("ROUNDEDCORNERS", [14,14,14,14]),
        ]))
        return Table([[tbl]], colWidths=[w], style=[
            ("ALIGN", (0,0), (-1,-1), "CENTER"),
            ("VALIGN", (0,0), (-1,-1), "MIDDLE"),
        ])

    def two_branch(left_text, right_text, lc=C_GREEN, rc=C_RED):
        l = Table([[Paragraph(f"<font name='Helvetica-Bold' size='8.5' color='white'>{left_text}</font>",
                              ParagraphStyle("lb", alignment=TA_CENTER, leading=11))]],
                  colWidths=[w*0.44])
        l.setStyle(TableStyle([("BACKGROUND",(0,0),(-1,-1),lc),("BOX",(0,0),(-1,-1),1,lc),
                                ("TOPPADDING",(0,0),(-1,-1),5),("BOTTOMPADDING",(0,0),(-1,-1),5),
                                ("ROUNDEDCORNERS",[6,6,6,6])]))
        r = Table([[Paragraph(f"<font name='Helvetica-Bold' size='8.5' color='white'>{right_text}</font>",
                              ParagraphStyle("rb", alignment=TA_CENTER, leading=11))]],
                  colWidths=[w*0.44])
        r.setStyle(TableStyle([("BACKGROUND",(0,0),(-1,-1),rc),("BOX",(0,0),(-1,-1),1,rc),
                                ("TOPPADDING",(0,0),(-1,-1),5),("BOTTOMPADDING",(0,0),(-1,-1),5),
                                ("ROUNDEDCORNERS",[6,6,6,6])]))
        return Table([[l, "", r]], colWidths=[w*0.44, w*0.12, w*0.44])

    story.append(box("INTRAOPERATIVE BILE DUCT INJURY SUSPECTED", C_RED, C_RED))
    story.append(arrow())
    story.append(diamond("Is injury recognised INTRAOPERATIVELY?"))
    story.append(Spacer(1, 4))

    story.append(two_branch("YES — Recognised Intraop", "NO — Post-op Presentation"))
    story.append(Spacer(1, 4))

    # YES branch details
    yes_tbl = Table([[
        Paragraph("<b>Partial BDI:</b> Immediate primary repair ± T-tube\n"
                  "<b>Complete transection:</b> End-to-end repair or\n"
                  "hepaticojejunostomy by hepatobiliary surgeon\n"
                  "<b>Vascular co-injury:</b> Urgent vascular repair", BULLET)
    ]], colWidths=[w*0.44])
    yes_tbl.setStyle(TableStyle([("BACKGROUND",(0,0),(-1,-1),C_LIGHT_GREEN),
                                  ("BOX",(0,0),(-1,-1),1,C_GREEN),
                                  ("TOPPADDING",(0,0),(-1,-1),5),("BOTTOMPADDING",(0,0),(-1,-1),5),
                                  ("LEFTPADDING",(0,0),(-1,-1),6),
                                  ("ROUNDEDCORNERS",[6,6,6,6])]))

    no_tbl = Table([[
        Paragraph("<b>Bile leak / peritonitis:</b> Presents days 1-5\n"
                  "<b>Obstructive jaundice:</b> Days to weeks\n"
                  "<b>Investigations:</b> USS → CT → MRCP/ERCP\n"
                  "Drain any collections percutaneously", BULLET)
    ]], colWidths=[w*0.44])
    no_tbl.setStyle(TableStyle([("BACKGROUND",(0,0),(-1,-1),C_LIGHT_RED),
                                  ("BOX",(0,0),(-1,-1),1,C_RED),
                                  ("TOPPADDING",(0,0),(-1,-1),5),("BOTTOMPADDING",(0,0),(-1,-1),5),
                                  ("LEFTPADDING",(0,0),(-1,-1),6),
                                  ("ROUNDEDCORNERS",[6,6,6,6])]))
    story.append(Table([[yes_tbl, "", no_tbl]], colWidths=[w*0.44, w*0.12, w*0.44]))
    story.append(arrow())

    story.append(diamond("Injury Type / Strasberg Grade?", fill=colors.HexColor("#fef9e7"), stroke=C_ORANGE))
    story.append(Spacer(1, 4))

    grade_data = [
        [Paragraph("<b>Strasberg Grade</b>", SMALL_BOLD),
         Paragraph("<b>Description</b>", SMALL_BOLD),
         Paragraph("<b>Management</b>", SMALL_BOLD)],
        [Paragraph("A", BODY), Paragraph("Bile leak from cystic duct stump or minor duct", BODY),
         Paragraph("ERCP + stent / sphincterotomy", BODY)],
        [Paragraph("B", BODY), Paragraph("Occluded right posterior sectoral duct", BODY),
         Paragraph("Observation or surgical repair", BODY)],
        [Paragraph("C", BODY), Paragraph("Bile leak from divided right posterior duct", BODY),
         Paragraph("ERCP + stent; repair if persistent", BODY)],
        [Paragraph("D", BODY), Paragraph("Lateral injury to main bile duct, no tissue loss", BODY),
         Paragraph("Primary repair over T-tube", BODY)],
        [Paragraph("E1-E5", BODY), Paragraph("Transection/stricture of main bile duct at various levels", BODY),
         Paragraph("Hepaticojejunostomy (Roux-en-Y) by expert HBP surgeon", BODY)],
    ]
    grade_tbl = Table(grade_data, colWidths=[2.0*cm, 8.5*cm, 6.5*cm])
    grade_tbl.setStyle(TableStyle([
        ("BACKGROUND", (0,0), (-1,0), C_DARK_BLUE),
        ("TEXTCOLOR", (0,0), (-1,0), C_WHITE),
        ("BACKGROUND", (0,1), (-1,1), colors.HexColor("#d5f5e3")),
        ("BACKGROUND", (0,2), (-1,2), colors.HexColor("#d5f5e3")),
        ("BACKGROUND", (0,3), (-1,3), colors.HexColor("#fdebd0")),
        ("BACKGROUND", (0,4), (-1,4), colors.HexColor("#fdebd0")),
        ("BACKGROUND", (0,5), (-1,5), colors.HexColor("#fadbd8")),
        ("BOX", (0,0), (-1,-1), 1, C_MED_BLUE),
        ("INNERGRID", (0,0), (-1,-1), 0.4, C_GREY),
        ("TOPPADDING", (0,0), (-1,-1), 4),
        ("BOTTOMPADDING", (0,0), (-1,-1), 4),
        ("LEFTPADDING", (0,0), (-1,-1), 5),
        ("VALIGN", (0,0), (-1,-1), "TOP"),
    ]))
    story.append(grade_tbl)
    story.append(Spacer(1, 6))
    story.append(arrow())
    story.append(box("REFER TO SPECIALIST HBP UNIT if complex (E1-E5) or uncertain", C_PURPLE, C_PURPLE))

draw_flowchart_page1(story)
story.append(PageBreak())

# ══════════════════════════════════════════════════════════════════════════════
# PAGE 3 : FLOWCHART 2 — POST-OP MANAGEMENT
# ══════════════════════════════════════════════════════════════════════════════
story.append(section_header("FLOWCHART 2 — POST-OPERATIVE COMPLICATION ASSESSMENT"))
story.append(Spacer(1, 8))

w = doc.width

def centred_box(text, fill, stroke, col_w=None, height=32, fsize=9, bold=True):
    cw = col_w or w * 0.70
    fn = "Helvetica-Bold" if bold else "Helvetica"
    p = Paragraph(f"<font name='{fn}' size='{fsize}'>{text}</font>",
                  ParagraphStyle("cb", alignment=TA_CENTER, leading=13,
                                 textColor=C_WHITE))
    tbl = Table([[p]], colWidths=[cw])
    tbl.setStyle(TableStyle([
        ("BACKGROUND", (0,0), (-1,-1), fill),
        ("BOX", (0,0), (-1,-1), 1.5, stroke),
        ("TOPPADDING", (0,0), (-1,-1), 5),
        ("BOTTOMPADDING", (0,0), (-1,-1), 5),
        ("ROUNDEDCORNERS", [8,8,8,8]),
    ]))
    return Table([[tbl]], colWidths=[w], style=[("ALIGN",(0,0),(-1,-1),"CENTER")])

def small_arrow():
    d = Drawing(w, 14)
    mid = w/2
    d.add(Line(mid, 14, mid, 0, strokeColor=C_MED_BLUE, strokeWidth=1.5))
    d.add(Polygon([mid-4, 3, mid+4, 3, mid, 0], fillColor=C_MED_BLUE, strokeColor=C_MED_BLUE))
    return d

story.append(centred_box("PATIENT POST LAPAROSCOPIC CHOLECYSTECTOMY with NEW SYMPTOMS", C_DARK_BLUE, C_DARK_BLUE))
story.append(small_arrow())

# Symptom assessment
sym_data = [
    [Paragraph("<b>Key Symptoms to Assess</b>", ParagraphStyle("ksa", fontName="Helvetica-Bold", fontSize=9, textColor=C_WHITE, alignment=TA_CENTER))],
    [Table([
        [Paragraph("• Abdominal pain / peritonism", BULLET),
         Paragraph("• Fever / rigors / chills", BULLET)],
        [Paragraph("• Jaundice / dark urine", BULLET),
         Paragraph("• Nausea / vomiting", BULLET)],
        [Paragraph("• Shoulder-tip pain (referred)", BULLET),
         Paragraph("• Bile from drain / wound", BULLET)],
    ], colWidths=[w*0.48, w*0.48])],
]
sym_tbl = Table(sym_data, colWidths=[w])
sym_tbl.setStyle(TableStyle([
    ("BACKGROUND", (0,0), (0,0), C_MED_BLUE),
    ("BACKGROUND", (0,1), (0,1), C_SKY),
    ("BOX", (0,0), (-1,-1), 1, C_MED_BLUE),
    ("TOPPADDING", (0,0), (-1,-1), 5),
    ("BOTTOMPADDING", (0,0), (-1,-1), 5),
    ("LEFTPADDING", (0,0), (-1,-1), 6),
]))
story.append(sym_tbl)
story.append(small_arrow())

# Three pathways
p_bile = Table([[
    Paragraph("<b>BILIARY COMPLICATION?</b>", ParagraphStyle("bc", fontName="Helvetica-Bold", fontSize=8.5, textColor=C_WHITE, alignment=TA_CENTER)),
]], colWidths=[w*0.31])
p_bile.setStyle(TableStyle([("BACKGROUND",(0,0),(-1,-1),C_RED),("TOPPADDING",(0,0),(-1,-1),6),
                              ("BOTTOMPADDING",(0,0),(-1,-1),6),("BOX",(0,0),(-1,-1),1,C_RED),
                              ("ROUNDEDCORNERS",[6,6,6,6])]))

p_vasc = Table([[
    Paragraph("<b>VASCULAR / HAEMORRHAGE?</b>", ParagraphStyle("vc", fontName="Helvetica-Bold", fontSize=8.5, textColor=C_WHITE, alignment=TA_CENTER)),
]], colWidths=[w*0.31])
p_vasc.setStyle(TableStyle([("BACKGROUND",(0,0),(-1,-1),C_ORANGE),("TOPPADDING",(0,0),(-1,-1),6),
                              ("BOTTOMPADDING",(0,0),(-1,-1),6),("BOX",(0,0),(-1,-1),1,C_ORANGE),
                              ("ROUNDEDCORNERS",[6,6,6,6])]))

p_gen = Table([[
    Paragraph("<b>GENERAL SURGICAL?</b>", ParagraphStyle("gc", fontName="Helvetica-Bold", fontSize=8.5, textColor=C_WHITE, alignment=TA_CENTER)),
]], colWidths=[w*0.31])
p_gen.setStyle(TableStyle([("BACKGROUND",(0,0),(-1,-1),C_TEAL),("TOPPADDING",(0,0),(-1,-1),6),
                             ("BOTTOMPADDING",(0,0),(-1,-1),6),("BOX",(0,0),(-1,-1),1,C_TEAL),
                             ("ROUNDEDCORNERS",[6,6,6,6])]))

story.append(Table([[p_bile, "", p_vasc, "", p_gen]], colWidths=[w*0.31, w*0.02, w*0.31, w*0.04, w*0.31]))
story.append(Spacer(1, 4))

# Details for each pathway
d_bile = Table([[
    Paragraph("• Jaundice → USS → MRCP/ERCP\n"
              "• Bile peritonitis → CT → percutaneous drain\n"
              "• Small leak → observe or ERCP stent\n"
              "• Stricture → stent or surgical repair\n"
              "• Retained stone → ERCP extraction", BULLET)
]], colWidths=[w*0.31])
d_bile.setStyle(TableStyle([("BACKGROUND",(0,0),(-1,-1),C_LIGHT_RED),
                              ("BOX",(0,0),(-1,-1),1,C_RED),
                              ("TOPPADDING",(0,0),(-1,-1),5),("BOTTOMPADDING",(0,0),(-1,-1),5),
                              ("LEFTPADDING",(0,0),(-1,-1),4),
                              ("ROUNDEDCORNERS",[4,4,4,4])]))

d_vasc = Table([[
    Paragraph("• Active bleed → resuscitate\n"
              "• CT angiogram\n"
              "• Embolisation or re-operation\n"
              "• Trocar wound bleed: pressure /\n"
              "  tamponade / suture", BULLET)
]], colWidths=[w*0.31])
d_vasc.setStyle(TableStyle([("BACKGROUND",(0,0),(-1,-1),C_LIGHT_ORANGE),
                              ("BOX",(0,0),(-1,-1),1,C_ORANGE),
                              ("TOPPADDING",(0,0),(-1,-1),5),("BOTTOMPADDING",(0,0),(-1,-1),5),
                              ("LEFTPADDING",(0,0),(-1,-1),4),
                              ("ROUNDEDCORNERS",[4,4,4,4])]))

d_gen = Table([[
    Paragraph("• Wound infection → antibiotics, open\n"
              "• Incisional hernia → repair\n"
              "• Abscess → CT-guided drainage\n"
              "• Pancreatitis → supportive care\n"
              "• DVT/PE → anticoagulation", BULLET)
]], colWidths=[w*0.31])
d_gen.setStyle(TableStyle([("BACKGROUND",(0,0),(-1,-1),colors.HexColor("#d1f2eb")),
                             ("BOX",(0,0),(-1,-1),1,C_TEAL),
                             ("TOPPADDING",(0,0),(-1,-1),5),("BOTTOMPADDING",(0,0),(-1,-1),5),
                             ("LEFTPADDING",(0,0),(-1,-1),4),
                             ("ROUNDEDCORNERS",[4,4,4,4])]))
story.append(Table([[d_bile, "", d_vasc, "", d_gen]], colWidths=[w*0.31, w*0.02, w*0.31, w*0.04, w*0.31]))
story.append(Spacer(1, 6))
story.append(small_arrow())
story.append(centred_box("MULTIDISCIPLINARY REVIEW: Surgeon + Radiologist + Endoscopist", C_PURPLE, C_PURPLE, col_w=w*0.80))
story.append(PageBreak())

# ══════════════════════════════════════════════════════════════════════════════
# PAGE 4 : DETAILED COMPLICATIONS
# ══════════════════════════════════════════════════════════════════════════════
story.append(section_header("DETAILED COMPLICATIONS — BILIARY SYSTEM", C_RED))
story.append(Spacer(1, 6))

# Bile duct injury
bdi_data = [
    [Paragraph("<b>BILE DUCT INJURY (BDI)</b>", SMALL_BOLD),
     Paragraph("<b>Details</b>", SMALL_BOLD)],
    [Paragraph("Incidence", BODY), Paragraph("0.4-0.6% (LC) vs 0.1-0.2% (open)", BODY)],
    [Paragraph("Classic mechanism", BODY),
     Paragraph("CBD or RHD mistaken for cystic duct; traction aligns CBD with cystic duct making them appear as one", BODY)],
    [Paragraph("Risk factors", BODY),
     Paragraph("• Surgeon inexperience (1.7% risk in 1st case → 0.17% by 50th)\n"
               "• Aberrant anatomy\n"
               "• Dense adhesions / acute inflammation\n"
               "• Short cystic duct\n"
               "• Large Hartmann's pouch stone\n"
               "• Operative bleeding obscuring field", BODY)],
    [Paragraph("Recognition", BODY),
     Paragraph("Only 15% recognised intraoperatively; remainder present postoperatively as bile leak, biloma, peritonitis, or obstructive jaundice", BODY)],
    [Paragraph("Prevention", BODY),
     Paragraph("Critical view of safety (CVS): dissect Calot's triangle until only two structures seen entering GB base; consider intraoperative cholangiography", BODY)],
    [Paragraph("Management", BODY),
     Paragraph("Partial: primary repair ± T-tube\nComplete transection: Roux-en-Y hepaticojejunostomy\nComplex (E1-E5): specialist HBP centre", BODY)],
]
bdi_tbl = Table(bdi_data, colWidths=[4*cm, 13*cm])
bdi_tbl.setStyle(TableStyle([
    ("BACKGROUND", (0,0), (-1,0), C_RED),
    ("TEXTCOLOR", (0,0), (-1,0), C_WHITE),
    ("BACKGROUND", (0,1), (-1,1), C_LIGHT_RED),
    ("BACKGROUND", (0,2), (-1,2), C_WHITE),
    ("BACKGROUND", (0,3), (-1,3), C_LIGHT_RED),
    ("BACKGROUND", (0,4), (-1,4), C_WHITE),
    ("BACKGROUND", (0,5), (-1,5), C_LIGHT_RED),
    ("BACKGROUND", (0,6), (-1,6), C_WHITE),
    ("BOX", (0,0), (-1,-1), 1, C_RED),
    ("INNERGRID", (0,0), (-1,-1), 0.4, colors.HexColor("#f1948a")),
    ("TOPPADDING", (0,0), (-1,-1), 5),
    ("BOTTOMPADDING", (0,0), (-1,-1), 5),
    ("LEFTPADDING", (0,0), (-1,-1), 6),
    ("VALIGN", (0,0), (-1,-1), "TOP"),
]))
story.append(bdi_tbl)
story.append(Spacer(1, 8))

# Bile leak
bl_data = [
    [Paragraph("<b>BILE LEAK</b>", SMALL_BOLD), Paragraph("<b>Details</b>", SMALL_BOLD)],
    [Paragraph("Sources", BODY), Paragraph("Cystic duct stump, gallbladder fossa ducts (Luschka's ducts), main bile duct", BODY)],
    [Paragraph("Presentation", BODY), Paragraph("Abdominal pain, fever, peritonitis (bile peritonitis if no drain); bile from drain", BODY)],
    [Paragraph("Investigation", BODY), Paragraph("USS → CT → ERCP (diagnostic and therapeutic)", BODY)],
    [Paragraph("Management", BODY), Paragraph("Small leaks: observation (often self-limiting if no distal obstruction)\n"
                                               "Symptomatic: ERCP + sphincterotomy ± stent\n"
                                               "Collections: percutaneous/surgical drainage", BODY)],
]
bl_tbl = Table(bl_data, colWidths=[4*cm, 13*cm])
bl_tbl.setStyle(TableStyle([
    ("BACKGROUND", (0,0), (-1,0), C_ORANGE),
    ("TEXTCOLOR", (0,0), (-1,0), C_WHITE),
    ("ROWBACKGROUNDS", (0,1), (-1,-1), [C_LIGHT_ORANGE, C_WHITE]),
    ("BOX", (0,0), (-1,-1), 1, C_ORANGE),
    ("INNERGRID", (0,0), (-1,-1), 0.4, colors.HexColor("#f0b27a")),
    ("TOPPADDING", (0,0), (-1,-1), 5),
    ("BOTTOMPADDING", (0,0), (-1,-1), 5),
    ("LEFTPADDING", (0,0), (-1,-1), 6),
    ("VALIGN", (0,0), (-1,-1), "TOP"),
]))
story.append(bl_tbl)
story.append(Spacer(1, 8))

# Retained stones
rs_data = [
    [Paragraph("<b>RETAINED / SPILLED STONES</b>", SMALL_BOLD), Paragraph("<b>Details</b>", SMALL_BOLD)],
    [Paragraph("Spilled stones", BODY), Paragraph("Gallbladder perforation occurs in 10-40% of LC cases; spilled stones in 5-40%", BODY)],
    [Paragraph("Consequences", BODY), Paragraph("Intra-abdominal abscess, subcutaneous abscess, biliary-cutaneous fistula, trocar-site abscess (months–years later)", BODY)],
    [Paragraph("Retained CBD stones", BODY), Paragraph("Presents with pain, pancreatitis, jaundice post-op; ERCP is treatment of choice", BODY)],
    [Paragraph("Prevention", BODY), Paragraph("Retrieve all spilled stones; use retrieval bag for GB extraction", BODY)],
]
rs_tbl = Table(rs_data, colWidths=[4*cm, 13*cm])
rs_tbl.setStyle(TableStyle([
    ("BACKGROUND", (0,0), (-1,0), C_TEAL),
    ("TEXTCOLOR", (0,0), (-1,0), C_WHITE),
    ("ROWBACKGROUNDS", (0,1), (-1,-1), [colors.HexColor("#d1f2eb"), C_WHITE]),
    ("BOX", (0,0), (-1,-1), 1, C_TEAL),
    ("INNERGRID", (0,0), (-1,-1), 0.4, C_GREY),
    ("TOPPADDING", (0,0), (-1,-1), 5),
    ("BOTTOMPADDING", (0,0), (-1,-1), 5),
    ("LEFTPADDING", (0,0), (-1,-1), 6),
    ("VALIGN", (0,0), (-1,-1), "TOP"),
]))
story.append(rs_tbl)
story.append(PageBreak())

# ══════════════════════════════════════════════════════════════════════════════
# PAGE 5 : VASCULAR + PNEUMOPERITONEUM + TROCAR
# ══════════════════════════════════════════════════════════════════════════════
story.append(section_header("VASCULAR, PNEUMOPERITONEUM & TROCAR COMPLICATIONS", C_DARK_BLUE))
story.append(Spacer(1, 6))

# Vascular
vasc_data = [
    [Paragraph("<b>VASCULAR / HAEMORRHAGIC COMPLICATIONS</b>", SMALL_BOLD), ""],
    [Paragraph("Cystic artery bleeding", BODY),
     Paragraph("Most common intraop bleed; controlled by haemostatic clips or conversion to open", BODY)],
    [Paragraph("Right hepatic artery injury", BODY),
     Paragraph("Often co-exists with BDI (close anatomic relationship); may cause hepatic ischaemia; urgent repair needed", BODY)],
    [Paragraph("Major vessel injury (aorta, IVC, iliac)", BODY),
     Paragraph("During trocar insertion especially with closed technique; do NOT remove trocar — open immediately and isolate vessel", BODY)],
    [Paragraph("Abdominal wall vessel (epigastric)", BODY),
     Paragraph("Trocar laceration; controlled with Foley catheter tamponade or through-and-through suture", BODY)],
]
vasc_tbl = Table(vasc_data, colWidths=[5*cm, 12*cm])
vasc_tbl.setStyle(TableStyle([
    ("BACKGROUND", (0,0), (-1,0), C_DARK_BLUE),
    ("TEXTCOLOR", (0,0), (-1,0), C_WHITE),
    ("SPAN", (0,0), (1,0)),
    ("ROWBACKGROUNDS", (0,1), (-1,-1), [C_LIGHT_BLUE, C_WHITE]),
    ("BOX", (0,0), (-1,-1), 1, C_DARK_BLUE),
    ("INNERGRID", (0,0), (-1,-1), 0.4, C_GREY),
    ("TOPPADDING", (0,0), (-1,-1), 5),
    ("BOTTOMPADDING", (0,0), (-1,-1), 5),
    ("LEFTPADDING", (0,0), (-1,-1), 6),
    ("VALIGN", (0,0), (-1,-1), "TOP"),
]))
story.append(vasc_tbl)
story.append(Spacer(1, 8))

# Pneumoperitoneum
pneu_data = [
    [Paragraph("<b>PNEUMOPERITONEUM-RELATED COMPLICATIONS</b>", SMALL_BOLD), "", ""],
    [Paragraph("<b>Complication</b>", SMALL_BOLD), Paragraph("<b>Mechanism</b>", SMALL_BOLD), Paragraph("<b>Management</b>", SMALL_BOLD)],
    [Paragraph("CO2 Gas Embolism", BODY), Paragraph("CO2 enters torn vessel during insufflation", BODY),
     Paragraph("Deflate pneumoperitoneum; left lateral decubitus; 100% O2; CPR if arrest", BODY)],
    [Paragraph("Vaso-vagal Reflex", BODY), Paragraph("Peritoneal stretch → bradycardia", BODY),
     Paragraph("Deflate; atropine", BODY)],
    [Paragraph("Cardiac Arrhythmias", BODY), Paragraph("Hypercarbia → sympathetic activation", BODY),
     Paragraph("Ventilation adjustment; anti-arrhythmics", BODY)],
    [Paragraph("Hypercarbic Acidosis", BODY), Paragraph("CO2 absorption especially in long cases", BODY),
     Paragraph("Increase ventilation; reduce insufflation pressure", BODY)],
    [Paragraph("Subcutaneous Emphysema", BODY), Paragraph("CO2 tracking into subcutaneous tissue", BODY),
     Paragraph("Usually self-limiting; monitor", BODY)],
    [Paragraph("Pneumothorax / Pneumomediastinum", BODY), Paragraph("CO2 tracking through diaphragmatic defect", BODY),
     Paragraph("Chest drain if tension; otherwise conservative", BODY)],
]
pneu_tbl = Table(pneu_data, colWidths=[5*cm, 5.5*cm, 6.5*cm])
pneu_tbl.setStyle(TableStyle([
    ("BACKGROUND", (0,0), (-1,0), C_MED_BLUE),
    ("TEXTCOLOR", (0,0), (-1,0), C_WHITE),
    ("SPAN", (0,0), (2,0)),
    ("BACKGROUND", (0,1), (-1,1), C_DARK_BLUE),
    ("TEXTCOLOR", (0,1), (-1,1), C_WHITE),
    ("ROWBACKGROUNDS", (0,2), (-1,-1), [C_LIGHT_BLUE, C_WHITE]),
    ("BOX", (0,0), (-1,-1), 1, C_MED_BLUE),
    ("INNERGRID", (0,0), (-1,-1), 0.4, C_GREY),
    ("TOPPADDING", (0,0), (-1,-1), 5),
    ("BOTTOMPADDING", (0,0), (-1,-1), 5),
    ("LEFTPADDING", (0,0), (-1,-1), 6),
    ("VALIGN", (0,0), (-1,-1), "TOP"),
]))
story.append(pneu_tbl)
story.append(Spacer(1, 8))

# Trocar
trocar_data = [
    [Paragraph("<b>TROCAR / ACCESS COMPLICATIONS</b>", SMALL_BOLD), ""],
    [Paragraph("GI tract perforation (bowel)", BODY),
     Paragraph("Most common with blind trocar insertion; Veress needle injury can be managed conservatively; trocar bowel injury requires repair", BODY)],
    [Paragraph("GU tract injury (bladder)", BODY),
     Paragraph("Seen with prior pelvic surgery; Foley catheter decompression preoperative; intraop repair if recognised", BODY)],
    [Paragraph("Trocar-site hernia (port-site hernia)", BODY),
     Paragraph("Incidence 1-3%; higher at 10-12mm ports; prevent by closing fascial defects ≥10mm; treat with elective repair", BODY)],
    [Paragraph("Wound infection", BODY),
     Paragraph("Higher risk with acute cholecystitis, gallbladder perforation, or immunocompromise; treat with antibiotics ± drainage", BODY)],
    [Paragraph("Port-site metastasis", BODY),
     Paragraph("Rare; reported with unsuspected gallbladder carcinoma; use retrieval bag", BODY)],
]
trocar_tbl = Table(trocar_data, colWidths=[5*cm, 12*cm])
trocar_tbl.setStyle(TableStyle([
    ("BACKGROUND", (0,0), (-1,0), C_PURPLE),
    ("TEXTCOLOR", (0,0), (-1,0), C_WHITE),
    ("SPAN", (0,0), (1,0)),
    ("ROWBACKGROUNDS", (0,1), (-1,-1), [C_LIGHT_PURPLE, C_WHITE]),
    ("BOX", (0,0), (-1,-1), 1, C_PURPLE),
    ("INNERGRID", (0,0), (-1,-1), 0.4, C_GREY),
    ("TOPPADDING", (0,0), (-1,-1), 5),
    ("BOTTOMPADDING", (0,0), (-1,-1), 5),
    ("LEFTPADDING", (0,0), (-1,-1), 6),
    ("VALIGN", (0,0), (-1,-1), "TOP"),
]))
story.append(trocar_tbl)
story.append(PageBreak())

# ══════════════════════════════════════════════════════════════════════════════
# PAGE 6 : STRASBERG CLASSIFICATION + DIAGRAM
# ══════════════════════════════════════════════════════════════════════════════
story.append(section_header("STRASBERG CLASSIFICATION OF BILE DUCT INJURIES", C_DARK_BLUE))
story.append(Spacer(1, 8))

# Embed Strasberg image
if os.path.exists(strasberg_path):
    img = Image(strasberg_path, width=doc.width*0.95, height=8*cm)
    img.hAlign = "CENTER"
    story.append(img)
    story.append(Paragraph("Figure: Strasberg Classification of Bile Duct Injuries — Bailey & Love's Surgery 28th Edition", CAPTION))
story.append(Spacer(1, 8))

stras_data = [
    [Paragraph("<b>Grade</b>", SMALL_BOLD), Paragraph("<b>Description</b>", SMALL_BOLD),
     Paragraph("<b>Anatomical Injury</b>", SMALL_BOLD), Paragraph("<b>Treatment</b>", SMALL_BOLD)],
    [Paragraph("A", BODY), Paragraph("Bile leak — minor", BODY),
     Paragraph("Cystic duct stump / Luschka duct", BODY), Paragraph("ERCP + sphincterotomy ± stent", BODY)],
    [Paragraph("B", BODY), Paragraph("Occlusion — no leak", BODY),
     Paragraph("Right posterior sectoral duct occluded", BODY), Paragraph("Observe or surgical repair", BODY)],
    [Paragraph("C", BODY), Paragraph("Bile leak — sectoral", BODY),
     Paragraph("Right posterior sectoral duct divided + leaking", BODY), Paragraph("ERCP + stent; repair if persistent", BODY)],
    [Paragraph("D", BODY), Paragraph("Lateral injury", BODY),
     Paragraph("Lateral laceration of main bile duct; no tissue loss", BODY), Paragraph("Primary repair over T-tube", BODY)],
    [Paragraph("E1", BODY), Paragraph("Transection — distal", BODY),
     Paragraph("Stricture >2 cm from hepatic hilus", BODY), Paragraph("Hepaticojejunostomy", BODY)],
    [Paragraph("E2", BODY), Paragraph("Transection — mid", BODY),
     Paragraph("Stricture <2 cm from hepatic hilus", BODY), Paragraph("Hepaticojejunostomy", BODY)],
    [Paragraph("E3", BODY), Paragraph("Hilar — R+L in continuity", BODY),
     Paragraph("Stricture at hilus; R and L hepatic ducts communicate", BODY), Paragraph("Complex Roux-en-Y (specialist)", BODY)],
    [Paragraph("E4", BODY), Paragraph("Hilar — R+L separated", BODY),
     Paragraph("Stricture with separation of right and left hepatic ducts", BODY), Paragraph("Complex biliary reconstruction", BODY)],
    [Paragraph("E5", BODY), Paragraph("Combined injury", BODY),
     Paragraph("Right aberrant sectoral duct + main bile duct stricture", BODY), Paragraph("Specialist HBP reconstruction", BODY)],
]
stras_tbl = Table(stras_data, colWidths=[1.4*cm, 3.5*cm, 6.5*cm, 5.6*cm])
stras_tbl.setStyle(TableStyle([
    ("BACKGROUND", (0,0), (-1,0), C_DARK_BLUE),
    ("TEXTCOLOR", (0,0), (-1,0), C_WHITE),
    ("BACKGROUND", (0,1), (-1,1), colors.HexColor("#d5f5e3")),
    ("BACKGROUND", (0,2), (-1,2), colors.HexColor("#d5f5e3")),
    ("BACKGROUND", (0,3), (-1,3), colors.HexColor("#fdebd0")),
    ("BACKGROUND", (0,4), (-1,4), colors.HexColor("#fdebd0")),
    ("BACKGROUND", (0,5), (-1,5), colors.HexColor("#fadbd8")),
    ("BACKGROUND", (0,6), (-1,6), colors.HexColor("#fadbd8")),
    ("BACKGROUND", (0,7), (-1,7), colors.HexColor("#fadbd8")),
    ("BACKGROUND", (0,8), (-1,8), colors.HexColor("#fadbd8")),
    ("BACKGROUND", (0,9), (-1,9), colors.HexColor("#fadbd8")),
    ("BOX", (0,0), (-1,-1), 1, C_MED_BLUE),
    ("INNERGRID", (0,0), (-1,-1), 0.4, C_GREY),
    ("TOPPADDING", (0,0), (-1,-1), 4),
    ("BOTTOMPADDING", (0,0), (-1,-1), 4),
    ("LEFTPADDING", (0,0), (-1,-1), 5),
    ("VALIGN", (0,0), (-1,-1), "TOP"),
]))
story.append(stras_tbl)
story.append(PageBreak())

# ══════════════════════════════════════════════════════════════════════════════
# PAGE 7 : FLOWCHART 3 — CONVERSION TO OPEN
# ══════════════════════════════════════════════════════════════════════════════
story.append(section_header("FLOWCHART 3 — DIFFICULT CHOLECYSTECTOMY: BAIL-OUT STRATEGIES"))
story.append(Spacer(1, 10))

def flow_box_row(text, fill, stroke, col_w=None, fsize=9.5):
    cw = col_w or w * 0.72
    p = Paragraph(f"<font name='Helvetica-Bold' size='{fsize}' color='white'>{text}</font>",
                  ParagraphStyle("fbr", alignment=TA_CENTER, leading=13))
    t = Table([[p]], colWidths=[cw])
    t.setStyle(TableStyle([("BACKGROUND",(0,0),(-1,-1),fill),("BOX",(0,0),(-1,-1),1.5,stroke),
                            ("TOPPADDING",(0,0),(-1,-1),6),("BOTTOMPADDING",(0,0),(-1,-1),6),
                            ("ROUNDEDCORNERS",[8,8,8,8])]))
    return Table([[t]], colWidths=[w], style=[("ALIGN",(0,0),(-1,-1),"CENTER")])

def arr():
    d = Drawing(w, 15)
    m = w/2
    d.add(Line(m, 15, m, 0, strokeColor=C_DARK_BLUE, strokeWidth=2))
    d.add(Polygon([m-5, 4, m+5, 4, m, 0], fillColor=C_DARK_BLUE, strokeColor=C_DARK_BLUE))
    return d

story.append(flow_box_row("DIFFICULT LAPAROSCOPIC CHOLECYSTECTOMY", C_DARK_BLUE, C_DARK_BLUE, fsize=11))
story.append(arr())

# Warning signs
warn_data = [
    [Paragraph("<b>Warning Signs / Triggers for Bail-out</b>", ParagraphStyle("ws", fontName="Helvetica-Bold",
                fontSize=9.5, textColor=C_WHITE, alignment=TA_CENTER))],
    [Table([
        [Paragraph("• Anatomy not clearly defined", BULLET),
         Paragraph("• No progress with dissection", BULLET),
         Paragraph("• Active uncontrolled bleeding", BULLET)],
        [Paragraph("• Dense adhesions / frozen pelvis", BULLET),
         Paragraph("• Mirizzi syndrome suspected", BULLET),
         Paragraph("• BDI risk is high", BULLET)],
    ], colWidths=[w*0.33]*3)],
]
warn_tbl = Table(warn_data, colWidths=[w])
warn_tbl.setStyle(TableStyle([
    ("BACKGROUND",(0,0),(0,0), C_RED),
    ("BACKGROUND",(0,1),(0,1), C_LIGHT_RED),
    ("BOX",(0,0),(-1,-1),1,C_RED),
    ("TOPPADDING",(0,0),(-1,-1),5),("BOTTOMPADDING",(0,0),(-1,-1),5),
    ("LEFTPADDING",(0,0),(-1,-1),4),
]))
story.append(warn_tbl)
story.append(arr())

# 5 bail-out options
bail_options = [
    ("1. CONVERT TO OPEN", C_ORANGE, "Choose early — 'by choice' not forced by complication"),
    ("2. SUBTOTAL CHOLECYSTECTOMY", C_MED_BLUE, "Remove GB fundus/body; leave Hartmann's pouch; safer than risky dissection"),
    ("3. TUBE CHOLECYSTOSTOMY", C_TEAL, "14Fr Foley catheter; temporary relief; definitive surgery later"),
    ("4. FUNDUS-FIRST APPROACH", C_PURPLE, "Dissect from fundus down instead of Calot's triangle"),
    ("5. INTRAOPERATIVE CHOLANGIOGRAPHY", C_GREEN, "Delineate biliary anatomy when in doubt; reduces BDI risk"),
]
for title, fill, desc in bail_options:
    opt_tbl = Table([[
        Table([[Paragraph(f"<font name='Helvetica-Bold' size='9' color='white'>{title}</font>",
                          ParagraphStyle("op", alignment=TA_CENTER, leading=12))]],
              colWidths=[5.5*cm],
              style=[("BACKGROUND",(0,0),(-1,-1),fill),("TOPPADDING",(0,0),(-1,-1),6),
                     ("BOTTOMPADDING",(0,0),(-1,-1),6),("ROUNDEDCORNERS",[6,6,6,6]),
                     ("BOX",(0,0),(-1,-1),1,fill)]),
        Paragraph(desc, BODY)
    ]], colWidths=[5.5*cm, w - 5.5*cm - 0.5*cm])
    opt_tbl.setStyle(TableStyle([
        ("BACKGROUND",(0,0),(-1,-1),C_LIGHT_GREY),
        ("BOX",(0,0),(-1,-1),0.5,C_GREY),
        ("TOPPADDING",(0,0),(-1,-1),4),("BOTTOMPADDING",(0,0),(-1,-1),4),
        ("LEFTPADDING",(0,0),(-1,-1),5),
        ("VALIGN",(0,0),(-1,-1),"MIDDLE"),
        ("ROUNDEDCORNERS",[4,4,4,4]),
    ]))
    story.append(opt_tbl)
    story.append(Spacer(1, 4))

story.append(arr())
story.append(flow_box_row("DOCUMENT DECISION + INFORM PATIENT POST-OP", C_GREEN, C_GREEN, fsize=10))
story.append(PageBreak())

# ══════════════════════════════════════════════════════════════════════════════
# PAGE 8 : PREVENTION & SUMMARY
# ══════════════════════════════════════════════════════════════════════════════
story.append(section_header("PREVENTION OF COMPLICATIONS & CLINICAL PEARLS", C_GREEN))
story.append(Spacer(1, 8))

# Critical view of safety
cvs_data = [
    [Paragraph("<b>THE CRITICAL VIEW OF SAFETY (CVS)</b>", SMALL_BOLD), ""],
    [Paragraph("Requirement 1", BODY),
     Paragraph("Hepatocystic triangle is cleared of fat and fibrous tissue", BODY)],
    [Paragraph("Requirement 2", BODY),
     Paragraph("Lower third of gallbladder is separated from liver bed", BODY)],
    [Paragraph("Requirement 3", BODY),
     Paragraph("Only TWO structures seen entering the gallbladder (cystic duct + cystic artery)", BODY)],
    [Paragraph("Clinical Pearl", BODY),
     Paragraph("⚠️  Do NOT clip any structure until CVS is achieved. When in doubt, do NOT clip.", BODY)],
]
cvs_tbl = Table(cvs_data, colWidths=[4.5*cm, 12.5*cm])
cvs_tbl.setStyle(TableStyle([
    ("BACKGROUND",(0,0),(-1,0), C_GREEN),("TEXTCOLOR",(0,0),(-1,0),C_WHITE),
    ("SPAN",(0,0),(1,0)),
    ("ROWBACKGROUNDS",(0,1),(-1,-1),[C_LIGHT_GREEN,C_WHITE]),
    ("BOX",(0,0),(-1,-1),1,C_GREEN),
    ("INNERGRID",(0,0),(-1,-1),0.4,C_GREY),
    ("TOPPADDING",(0,0),(-1,-1),5),("BOTTOMPADDING",(0,0),(-1,-1),5),
    ("LEFTPADDING",(0,0),(-1,-1),6),("VALIGN",(0,0),(-1,-1),"TOP"),
]))
story.append(cvs_tbl)
story.append(Spacer(1, 8))

# Key prevention table
prev_data = [
    [Paragraph("<b>Complication</b>", SMALL_BOLD), Paragraph("<b>Key Prevention Strategy</b>", SMALL_BOLD)],
    [Paragraph("Bile duct injury", BODY), Paragraph("CVS; intraoperative cholangiography; early conversion if anatomy unclear; go fundus-first", BODY)],
    [Paragraph("Major vessel injury", BODY), Paragraph("Never aim trocar at spine; use hand as brake; open technique for high-risk patients", BODY)],
    [Paragraph("Gallbladder perforation / spilled stones", BODY), Paragraph("Gentle dissection; use retrieval bag; retrieve all spilled stones meticulously", BODY)],
    [Paragraph("Port-site hernia", BODY), Paragraph("Close fascial defects at all ≥10mm ports", BODY)],
    [Paragraph("CO2 embolism", BODY), Paragraph("Low insufflation pressure; avoid Trendelenburg until peritoneum established", BODY)],
    [Paragraph("Pancreatitis", BODY), Paragraph("Intraoperative cholangiography; ERCP for retained stones if suspected", BODY)],
    [Paragraph("Wound infection", BODY), Paragraph("Perioperative antibiotics in acute cholecystitis; retrieval bag prevents GB contamination", BODY)],
]
prev_tbl = Table(prev_data, colWidths=[5*cm, 12*cm])
prev_tbl.setStyle(TableStyle([
    ("BACKGROUND",(0,0),(-1,0), C_DARK_BLUE),("TEXTCOLOR",(0,0),(-1,0),C_WHITE),
    ("ROWBACKGROUNDS",(0,1),(-1,-1),[C_LIGHT_BLUE,C_WHITE]),
    ("BOX",(0,0),(-1,-1),1,C_DARK_BLUE),
    ("INNERGRID",(0,0),(-1,-1),0.4,C_GREY),
    ("TOPPADDING",(0,0),(-1,-1),5),("BOTTOMPADDING",(0,0),(-1,-1),5),
    ("LEFTPADDING",(0,0),(-1,-1),6),("VALIGN",(0,0),(-1,-1),"TOP"),
]))
story.append(prev_tbl)
story.append(Spacer(1, 10))

# Summary box
summ_tbl = Table([[
    Paragraph("<b>KEY TAKEAWAYS</b>", ParagraphStyle("kt", fontName="Helvetica-Bold", fontSize=11, textColor=C_WHITE, alignment=TA_CENTER))
],[
    Paragraph(
        "• Overall mortality &lt;0.3%; complications 10-15% of cases\n"
        "• Bile duct injury is the most feared complication: 0.4-0.6% (LC) vs 0.1-0.2% (open)\n"
        "• Only 15% of BDIs are recognised intraoperatively\n"
        "• Critical View of Safety (CVS) is the single most important preventive measure\n"
        "• When in doubt — stop, call for help, convert, or use intraoperative cholangiography\n"
        "• Spilled stones must always be retrieved to prevent late abscesses\n"
        "• Complex BDI (E1-E5) mandates referral to specialist HBP centre\n"
        "• MDT (surgeon + radiologist + endoscopist) is essential for post-op complication management",
        BULLET)
]], colWidths=[w])
summ_tbl.setStyle(TableStyle([
    ("BACKGROUND",(0,0),(-1,0),C_DARK_BLUE),
    ("BACKGROUND",(0,1),(-1,1),C_SKY),
    ("BOX",(0,0),(-1,-1),2,C_DARK_BLUE),
    ("TOPPADDING",(0,0),(-1,-1),8),("BOTTOMPADDING",(0,0),(-1,-1),8),
    ("LEFTPADDING",(0,0),(-1,-1),10),
    ("ROUNDEDCORNERS",[8,8,8,8]),
]))
story.append(summ_tbl)
story.append(Spacer(1, 6))
story.append(Paragraph(
    "References: Maingot's Abdominal Operations 12e | Bailey & Love's Short Practice of Surgery 28e | "
    "Mulholland & Greenfield's Surgery 7e | Tintinalli's Emergency Medicine",
    SOURCE))

# ── BUILD ──────────────────────────────────────────────────────────────────────
def on_first_page(canvas, doc):
    pass

def on_later_pages(canvas, doc):
    canvas.saveState()
    canvas.setFont("Helvetica", 7.5)
    canvas.setFillColor(C_GREY)
    canvas.drawCentredString(A4[0]/2, 1.2*cm, f"Complications of Laparoscopic Cholecystectomy  |  Page {doc.page}")
    canvas.restoreState()

doc.build(story, onFirstPage=on_first_page, onLaterPages=on_later_pages)
print(f"PDF saved to: {OUTPUT}")

Successfully replaced 1 instance(s) of the string in '/tmp/workspace/lap-chole-pdf/generate_pdf.py'

Successfully replaced 1 instance(s) of the string in '/tmp/workspace/lap-chole-pdf/generate_pdf.py'