Presentation and management of gallbladder remnant after partial cholecystectomy

Jayant, Mayank; Kaushik, Robin

doi:10.7869/tg.2012.106

Cited by 14 publications

(14 citation statements)

References 12 publications

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“…This outcome may be attributed to an intact cystic duct with potential to drain into the gallbladder remnant, which likely serves as a reservoir for bile stasis, stone formation, and recurrent symptoms. 29 Incomplete evacuation of gallbladder contents at the time of subtotal cholecystectomy could also contribute to the observed recurrence of symptoms necessitating completion cholecystectomy. Interestingly, we observed that only patients in the laparoscopic subtotal cholecystectomy cohort underwent reoperation to remove the gallbladder remnant, whereas those that underwent a converted or planned open operation required no such intervention.…”

Section: Discussionmentioning

confidence: 99%

Subtotal cholecystectomy for the hostile gallbladder: failure to control the cystic duct results in significant morbidity

Lidsky

Speicher

Ezekian

et al. 2017

HPB

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Section: Discussionmentioning

confidence: 99%

Subtotal cholecystectomy for the hostile gallbladder: failure to control the cystic duct results in significant morbidity

Lidsky

Speicher

Ezekian

et al. 2017

HPB

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“…These series include 3 to 11 patients with time spans ranging from 3 to 9 years. It has been shown both, in our series and the literature that patients present over a highly variable and wide‐ranging amount of time after initial cholecystectomy (range 1 month to 40 years) . CT, MRCP, ultrasound, and ERCP were used most often for diagnosis, with MRCP being the only modality used in all studies.…”

Section: Discussionmentioning

confidence: 79%

“…Only 5% of all elective laparoscopic cholecystectomies are converted to open, typically due to inflammation and adhesions impairing safe dissection . This inflammatory environment predisposes the patient to having, intentionally or unintentionally, a gallbladder remnant left behind . In our series, 11 patients had a laparoscopic converted to open cholecystectomy at the initial surgery.…”

Section: Discussionmentioning

confidence: 97%

“…Prior studies indicate its occurrence following both open and laparoscopic cholecystectomies without a difference in frequency between the two approaches . Symptoms of a remnant gallbladder may arise shortly after a surgery or many years later . Upon presentation, providers often overlook a remnant gallbladder as a potential diagnosis given the patient's history of cholecystectomy and rarity of the condition.…”

Section: Introductionmentioning

confidence: 99%

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A diagnosis reconsidered: the symptomatic gallbladder remnant

Grossman

Johnston

Fowler

et al. 2019

J Hepato Biliary Pancreat

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Background Patients can present with symptomatic gallbladder disease after cholecystectomy due to a remnant gallbladder. This is a rare problem and challenging diagnosis with limited prior characterization; thus, we present a large series of patients with a gallbladder remnant. Methods A retrospective review was performed of all patients presenting with symptomatic gallbladder remnant at a tertiary care center from 2002 to 2016. Data on presenting symptoms, diagnostic tests, treatments, and follow-up were collected. Results Thirty-one patients diagnosed and treated for a symptomatic gallbladder remnant were identified. The most common presenting symptoms included right upper quadrant pain (87%) and nausea (55%). The median time from symptom presentation to definitive diagnosis was 60 days. Diagnostic modalities utilized in the evaluation of these patients demonstrated that endoscopic retrograde cholangiopancreatography and magnetic resonance cholangiopancreatography were effective with sensitivities of 85% and 90%, respectively. Twenty-three (76.2%) patients underwent completion cholecystectomy, which proved to be definitive treatment. Additionally, eight (25.8%) patients were non-operative candidates and underwent endoscopic retrograde cholangiopancreatography and sphincterotomy, three of whom developed recurrent symptoms.Conclusion A symptomatic gallbladder remnant after cholecystectomy is infrequently seen; however, the diagnosis should be considered in patients with recurrent biliary symptoms after cholecystectomy. Completion cholecystectomy can be challenging but is highly effective for definitive treatment.

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“…The most important cause of remnant gallbladder is the remaining gallbladder tissue in the partial cholecys-tectomy surgery due to poor visualization of the anatomy of the cystic duct and gallbladder junction for reasons such as hemorrhage, adhesion, or inflammation. Partial cholecystectomy is more common in cholecystectomy which is performed after acute cholecystitis [3,4].…”

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confidence: 99%

Remnant gallbladder stones: a rare cause of post-cholecystectomy syndrome

Çetin¹,

Aday²,

Çiyiltepe³

et al. 2017

Arch Med Sci Civil Dis

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Laparoscopic cholecystectomy is a widely accepted surgical treatment for symptomatic gallstones. Symptoms disappear after surgery in approximately 85% of patients. Post-cholecystectomy syndrome is defined as the continuation of pre-existing clinical symptoms or the development of new symptoms after cholecystectomy. These patients most often present with upper abdominal pain (mostly right upper quadrant pain) and dyspepsia complaints. Symptoms may occur in early and late post-operative periods (2 nd postoperative day -25 years) [1]. The causes of post-cholecystectomy syndrome may be biliary or extrabiliary. Remnant gallbladder is a very rare cause of post-cholecystectomy syndrome [2]. We present a case of symptomatic remnant gallbladder which is a rare cause of post-cholecystectomy syndrome.A 67-year-old male patient presented with occasional recurrent right upper quadrant pain and dyspeptic complaints. The patient had laparoscopic cholecystectomy due to acute cholecystitis about 10 months ago and endoscopic retrograde cholangiopancreatography (ERCP) due to choledocholithiasis about 3 months after the operation. On the physical examination, trocar site incisions were observed and there was slight tenderness in the right upper quadrant. Laboratory values were normal. In the upper gastrointestinal system endoscopy there were no features other than antral gastritis.Abdominal ultrasonography (USG) revealed a posterior shadow consistent with calculus in the gallbladder lodge. Unenhanced computed tomography (CT) of the upper abdomen and magnetic resonance cholangiopancreatography (MRCP) revealed a small line-shaped area in the gallbladder lodge consistent with a 15 mm sized stone at the level of the neck region connected to the cystic duct. The diameter of the choledochus was approximately 7-8 mm and no stone was seen (Figures 1 and 2). The cystic duct and remnant gallbladder were observed in the patient operated with preoperative diagnosis of remnant gallbladder stones and remnant cystic duct stones. Cholecystectomy was performed for the patient, who had an approximately 1.5 cm stone in the bladder neck. On the 4 th postoperative day, the patient was discharged without any problems. Post-cholecystectomy syndrome is defined as the continuation or recurrence of symptoms after cholecystectomy. Remnant gallbladder, which is one of the rare causes of post-cholecystectomy syndrome, can be seen due to inadequate cholecystectomy, partial cholecystectomy or congenital gallbladder duplication. The most important cause of remnant gallbladder is the remaining gallbladder tissue in the partial cholecys-

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Presentation and management of gallbladder remnant after partial cholecystectomy

Abstract: Background: Partial cholecystectomy is usually performed with the aim of preventing bile duct injury and/or vascular injuries in situations where there is difficulty in performing

Cited by 14 publications

References 12 publications

Subtotal cholecystectomy for the hostile gallbladder: failure to control the cystic duct results in significant morbidity

Subtotal cholecystectomy for the hostile gallbladder: failure to control the cystic duct results in significant morbidity

A diagnosis reconsidered: the symptomatic gallbladder remnant

Remnant gallbladder stones: a rare cause of post-cholecystectomy syndrome

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