Title: Post Cholecystectomy Stump Calculus Cholecystitis with Completion Cholecystectomy –A Rare Case Report

Authors: Dr Shrirang Yadwadkar, Dr Rajiv Chnadra, Dr Manish Motwani, Dr Jayant, Dr Swapnali

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i4.11

Abstract

Cholecystectomy is the most common method of choice for treating symptomatic gall stones. It can either be performed laproscopically or by open cholecystectomy. Partial cholecystectomy is usually done whenever there is difficulty in performing total cholecystectomy due to various reasons such as acute attack with adhesions, fibrosis, in view of preventing bile duct and vascular injuries, variations in anatomy which lead to bile duct remnant which can cause post cholecystectomy syndrome. After a partial or subtotal cholecystectomy, symptoms may recur from pathology in the gallbladder remnant. When this occurs, a completion cholecystectomy is required as treatment of choice.

We here report a case of a patient with stump cholecystitis in a gallbladder remnant to demonstrate open exploratory laparotomy with completion cholecystectomy.

Keywords: Cystic duct stump calculi, stump cholecystitis, completion cholecystectomy.

References

1.      Mayank Jayant, Robin Kaushik. Presentation and management of gallbla-dder remnant after partial cholecyst-ectomy; Tropical Gastroenterology  2013 Apr-Jun;34(2):99-10.

2.      Lerner AI. Partial cholecystectomy. Can Med Assoc J. 1950;63:54–6.

3.      Bornman PC, Terblanche J. Subtotal cholecystectomy: for the difficult gallbladder in portal hypertension and cholecystitis. Surgery. 1985;98:1–6

4.      A. K. Parmar,R.G.Khandelwal, M. J. Mathew, and P. K. Reddy, “Laparoscopic completion cholecystectomy: a retrospective study of 40 cases,” Asian Journal of Endoscopic Surgery, vol. 6, no. 2, pp. 96–99, 2013.

5.      Turner MA, Fulcher AS. The cystic duct normal anatomy and disease processes. Radiographics. 2001;21:3–22. [PubMed]

6.      Sherwinter DA, Subramanian SR, Cummings LS, Malit MF, Fink SL, Macura JM, et al. Cholecystectomy, Laparoscopic: emedicine. [Lastaccessed on 2010 Jul 16]. Available from: http://www.emedicine.medscape.com/article/1582292overview

7.      Sitenko VM, Nechai AI, Stukalov W, Kalashnikov SA. Large stump of the cystic duct. Vestn Khir Im I I Grek. 1976;116:56–9. [PubMed]

8.      Bodvall B, Overgaard B. CF duct remnant after cholecystectomy: incidence studied by cholegraphy in 500 cases, and significance in 103 reoperations. Ann Surg. 1966;163:382–5. [PMC free article] [PubMed]

9.      Rozses I, Magyarodi Z, Orban P. Cystic duct syndrome and minimally invasive surgery. Orv Hetil. 1997;138:2397–401. [PubMed]

10.  Lum YW, House MG, Hayanga AJ, Schweitzer M. Postcholecystectomy syndrome in the laparoscopic era. J Laparoendosc Adv Surg Tech A. 2006;16:482–5. [PubMed]

11.  Chow M, von Waldenfels A, Pace R. An unusual case of a retained stone following laparoscopic cholecystectomy. J Laparo-endosc Surg.1993;3:513–8. [PubMed]

12.  Price EA. The radiology of bile ducts. Br J Radiol. 1959;32:247-54.

13.  Hussain M, Nagral S. Biliary pancreatitis secondary to stones from a gall bladder remnant. Tropical Gastroenterology. 2010;31:230–3.

14.  Selvaggi F, Di Bartolomeo N, De Iuliis I, Del Ciotto N, Innocenti P. Laparoscopic treated socalled reformed gallbladder in patient with postcholecystectomy chronic pain. G Chir. 2011;32:335–7.

15.  Rogy MA, Függer R, Herbst F, Schulz F. Reoperation after cholecystectomy. The role of the cystic duct stump. HPB Surg. 1991;4:129–35

16.  Whitson BA, Wolpert SI. Cholelithiasis and cholecystitis in a retained gallbladder remnant after cholecystectomy. J Am Coll Surg. 2007;205:814–15.

17.  Calhoun SK, Piechowiak RL. Recurrent cholecystitis and cholelithiasis in a gallbladder remnant 14 years after a converted cholecystectomy. RCR. 2010;5 DOI: 10.2484/rcr.v5i1.33.

18.  Chowbey PK, Bandyopadhyay SK, Sharma A, Khullar R, Soni V, Baijal M. Laparoscopic reintervention for residual gallstone disease. Surg Laparosc Endosc Percutan Tech. 2003;13:31–5.

Corresponding Author

Dr Shrirang Yadwadkar

Address – M.T. Agrawal Hospital, Opposite ESIS Hospital, Off LBS Road, Mulund

(West), Mumbai-400080 Maharashtra

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