Surgical management of cystic duct stump calculi causing post-cholecystectomy syndrome: A prospective study
Aim: Remnant cystic duct stump calculi are an uncommon but important cause of 'post-cholecystectomy syndrome'. High index of suspicion is needed to diagnose this condition in a symptomatic post-cholecystectomy patient. We present our experience with the surgical management of this conditio...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2023-01-01
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| Series: | Journal of Minimal Access Surgery |
| Subjects: | |
| Online Access: | http://www.journalofmas.com/article.asp?issn=0972-9941;year=2023;volume=19;issue=2;spage=257;epage=262;aulast=Kumar |
| _version_ | 1797775490300248064 |
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| author | Saket Kumar Nishant Kurian Rakesh Kumar Singh Venkat Rao Chidipotu Sanjay Kumar Amarjit Kumar Raj Manish Mandal |
| author_facet | Saket Kumar Nishant Kurian Rakesh Kumar Singh Venkat Rao Chidipotu Sanjay Kumar Amarjit Kumar Raj Manish Mandal |
| author_sort | Saket Kumar |
| collection | DOAJ |
| description | Aim: Remnant cystic duct stump calculi are an uncommon but important cause of 'post-cholecystectomy syndrome'. High index of suspicion is needed to diagnose this condition in a symptomatic post-cholecystectomy patient. We present our experience with the surgical management of this condition.
Patients and Methods: This prospective study included 19 patients with residual gallstone disease who underwent completion cholecystectomy between August 2016 and October 2021. Investigations included abdominal ultrasound and magnetic resonance cholangiopancreatography. The demographic, clinical, surgical and early post-operative variables of these patients were prospectively maintained and analysed.
Results: The study included 14 women and 5 men. The mean age was 42.1 years (range, 14–80 years). The median duration between index surgery and completion cholecystectomy was 36 months (range, 2–178 months) (interquartile range, 105 months). The follow-up duration was 2 months. The initial surgery was open cholecystectomy in 17 and laparoscopic cholecystectomy in 2 patients. All patients with residual stump stone presented with pain, while 10 out of 19 patients complained of dyspepsia. Completion cholecystectomy could be performed laparoscopically in 16 cases, whereas 3 patients underwent open surgery. The mean operative time was 80 min (range, 55–140 min), and the mean blood loss was 100 ml (range, 50–160 ml). The mean hospital stay was 3 days (range, 2–10 days). No post-operative mortality or major morbidity was recorded in any of our patients.
Conclusion: Laparoscopic excision of the cystic duct stump is feasible and safe even after previous open cholecystectomy. It is increasingly becoming the treatment of choice where expertise is available. |
| first_indexed | 2024-03-12T22:36:28Z |
| format | Article |
| id | doaj.art-6ba675ea38d648829deac3191ce022b7 |
| institution | Directory Open Access Journal |
| issn | 0972-9941 1998-3921 |
| language | English |
| last_indexed | 2024-03-12T22:36:28Z |
| publishDate | 2023-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Minimal Access Surgery |
| spelling | doaj.art-6ba675ea38d648829deac3191ce022b72023-07-21T11:56:36ZengWolters Kluwer Medknow PublicationsJournal of Minimal Access Surgery0972-99411998-39212023-01-0119225726210.4103/jmas.jmas_75_22Surgical management of cystic duct stump calculi causing post-cholecystectomy syndrome: A prospective studySaket KumarNishant KurianRakesh Kumar SinghVenkat Rao ChidipotuSanjay KumarAmarjit Kumar RajManish MandalAim: Remnant cystic duct stump calculi are an uncommon but important cause of 'post-cholecystectomy syndrome'. High index of suspicion is needed to diagnose this condition in a symptomatic post-cholecystectomy patient. We present our experience with the surgical management of this condition. Patients and Methods: This prospective study included 19 patients with residual gallstone disease who underwent completion cholecystectomy between August 2016 and October 2021. Investigations included abdominal ultrasound and magnetic resonance cholangiopancreatography. The demographic, clinical, surgical and early post-operative variables of these patients were prospectively maintained and analysed. Results: The study included 14 women and 5 men. The mean age was 42.1 years (range, 14–80 years). The median duration between index surgery and completion cholecystectomy was 36 months (range, 2–178 months) (interquartile range, 105 months). The follow-up duration was 2 months. The initial surgery was open cholecystectomy in 17 and laparoscopic cholecystectomy in 2 patients. All patients with residual stump stone presented with pain, while 10 out of 19 patients complained of dyspepsia. Completion cholecystectomy could be performed laparoscopically in 16 cases, whereas 3 patients underwent open surgery. The mean operative time was 80 min (range, 55–140 min), and the mean blood loss was 100 ml (range, 50–160 ml). The mean hospital stay was 3 days (range, 2–10 days). No post-operative mortality or major morbidity was recorded in any of our patients. Conclusion: Laparoscopic excision of the cystic duct stump is feasible and safe even after previous open cholecystectomy. It is increasingly becoming the treatment of choice where expertise is available.http://www.journalofmas.com/article.asp?issn=0972-9941;year=2023;volume=19;issue=2;spage=257;epage=262;aulast=Kumarcystic duct stump stoneendoscopic retrograde cholangiopancreatographylaparoscopic cholecystectomypost-cholecystectomy syndrome |
| spellingShingle | Saket Kumar Nishant Kurian Rakesh Kumar Singh Venkat Rao Chidipotu Sanjay Kumar Amarjit Kumar Raj Manish Mandal Surgical management of cystic duct stump calculi causing post-cholecystectomy syndrome: A prospective study Journal of Minimal Access Surgery cystic duct stump stone endoscopic retrograde cholangiopancreatography laparoscopic cholecystectomy post-cholecystectomy syndrome |
| title | Surgical management of cystic duct stump calculi causing post-cholecystectomy syndrome: A prospective study |
| title_full | Surgical management of cystic duct stump calculi causing post-cholecystectomy syndrome: A prospective study |
| title_fullStr | Surgical management of cystic duct stump calculi causing post-cholecystectomy syndrome: A prospective study |
| title_full_unstemmed | Surgical management of cystic duct stump calculi causing post-cholecystectomy syndrome: A prospective study |
| title_short | Surgical management of cystic duct stump calculi causing post-cholecystectomy syndrome: A prospective study |
| title_sort | surgical management of cystic duct stump calculi causing post cholecystectomy syndrome a prospective study |
| topic | cystic duct stump stone endoscopic retrograde cholangiopancreatography laparoscopic cholecystectomy post-cholecystectomy syndrome |
| url | http://www.journalofmas.com/article.asp?issn=0972-9941;year=2023;volume=19;issue=2;spage=257;epage=262;aulast=Kumar |
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