Management of residual gallbladder and cystic duct stump stone after cholecystectomy: a retrospective study

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Abstract

Purpose
There is no doubt that cholecystectomy relieves presurgical symptoms of gallbladder (GB) disease. The persistence of symptoms following cholecystectomy is termed as postocolecystectomy syndrome, the incidence of which ranges from 10 to 30%. The present study was conducted to evaluate patients who had a residual GB stone/cystic duct stump stone after cholecystectomy, and to study the surgical outcomes.
Patients and methods
This retrospective study was conducted on 21 cases with residual GB/cystic duct stump stone. The diagnosis was guided by ultrasound and magnetic resonance cholangiopancreatography. All the cases were managed by using completion cholecystectomy − either open or laparoscopic. All preoperative, operative, and postoperative data were collected.
Results
Preoperative endoscopic retrograde cholangiopancreatography and papillotomy were required in nine cases that presented with obstructive jaundice. Laparoscopic completion cholecystecomy was feasible in 14 cases. The conversion rate was 1/14 cases. The mean operative time was 127±31.3?min and the mean blood loss was 165±74.5?ml. Intraoperative minor biliary injury occurred in one case. The mean hospital stay was 3.1±1.8 days (1–9 days). All patients were reported to be symptom-free at the follow-up after surgery.
Conclusion
Residual GB/cystic duct stump stone is a preventable and correctable cause of postocolecystectomy syndrome. Completion cholecystectomy is a proven treatment of choice to relieve symptoms and avoid complications, and, furthermore, it can be carried out laparoscopically.

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