Residual cystic duct: An independent risk factor for post-cholecystectomy syndrome, with 287 cases

The objective is to investigate the relationship between post-operative cystic syndrome (PCS) and post-operative residual cystic duct.

A retrospective analysis was performed on 287 patients diagnosed with cholecystolithiasis complicated with cystic inflammation who were admitted to the Second Affiliated Hospital of Kunming Medical University from August 2017 to September 2021. Residual cystic ducts >10 mm were included in the residual cystic duct group, and 5-10 mm were included in the non-residual cystic duct group. The two groups were compared for differences in cholecystitis, cholecystolithiasis, low confluence common bile duct, cystic duct dilation, duodenal papillary diverticulum, common bile duct calculus and ampullitis, and then, univariate and multivariate analyses were performed. Moreover, the characteristics of PCS cases in the residual cystic duct group and the non-residual cystic duct group and the differences in VAS pain index and duration of pain at different time points in post-operative follow-up.

The incidence of PCS was 21.73% in the residual cystic duct group and 9.23% in the non-residual cystic duct group ( P = 0.004). Overall, logistic multivariate analysis of 287 patients showed that cystic duct residue (OR = 2.308, 95% CI = 1.160-4.595, P = 0.017) was an independent risk factor for PCS.

Residual cystic duct (residual length of cystic duct >10 mm) is an independent risk factor for PCS. Compared with PCS without residual cystic duct, jaundice and abdominal pain are more serious and have no tendency to relieve. The probability of reoperation is high, which is worthy of attention in clinical diagnosis and treatment.