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Published on: March 28, 2025
Postcholecystectomy syndrome in the laparoscopic era
Ying Wei Lum1, Michael G House, Awori J Hayanga
1Department of Surgery, The Johns Hopkins Medical Institutions, Baltimore, Maryland 21224, USA.
Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
|September 29, 2006
Summary
A cystic duct remnant calculus, a rare cause of post-cholecystectomy syndrome, was successfully managed with laparoscopic excision after endoscopic removal of common bile duct stones. This case highlights a potential emerging complication of laparoscopic cholecystectomy.
Area of Science:
- Gastroenterology
- Surgical Innovation
- Biliary Tract Disease
Background:
- Laparoscopic cholecystectomy is a common procedure for gallstones.
- Post-cholecystectomy syndrome can present with various biliary complications.
- Cystic duct remnant calculi are a rare but significant cause of biliary obstruction.
Observation:
- A 45-year-old male presented with abdominal pain and jaundice post-laparoscopic cholecystectomy.
- Magnetic resonance cholangiopancreatography revealed an impacted calculus in the cystic duct remnant and common bile duct stones.
- Endoscopic retrograde cholangiopancreatography (ERCP) successfully removed common bile duct stones but not the cystic duct remnant calculus.
Findings:
- Successful laparoscopic excision of a 2.5-cm cystic duct remnant calculus was performed.
- Endoscopic management was unsuccessful for the cystic duct remnant calculus.
- The patient's symptoms were resolved following surgical intervention.
Implications:
- Cystic duct remnant calculi may represent an increasing cause of post-cholecystectomy syndrome.
- Laparoscopic excision remains a viable option for managing complex cystic duct remnant calculi.
- Further surveillance may be needed to assess the prevalence of this complication.
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