Cystic duct remnant and the 'post-cholecystectomy syndrome'.
Post-cholecystectomy syndrome refers to a wide spectrum of conditions that pose a challenging diagnostic dilemma. Cystic duct remnant, defined as a residual duct greater than 1 cm in length, may, in the presence of stones, cause post-cholecystectomy syndrome. In this report, 4 patients with post-cholecystectomy syndrome due to cystic duct remnant are described. All underwent laparoscopic cholecystectomy and one was converted to open. The patients presented with pain 10 months to 9 years post-cholecystectomy and investigations demonstrated cystic duct remnant. All patients underwent successful resection with resolution of symptoms. In this era of laparoscopic surgery, where surgery favors a long cystic duct remnant, we should be aware of cystic duct stones as a possible cause of postcholecystectomy syndrome. This report highlights magnetic resonance cholangiopancreatography as the optimal method for evaluating the biliary tract in these cases.
Shaw
Colette
C
Department of Surgery, Mater Misericordiae Hospital, Dublin, Ireland. coshaw@gofree.indigo.ie
O'Hanlon
Deirdre M
DM
Fenlon
Helen M
HM
McEntee
Gerry P
GP
D000328:Adult; D000368:Aged; D002758:Cholangiography / Q000379:methods*; D003549:Cystic Duct; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D017562:Postcholecystectomy Syndrome / Q000175:diagnosis* / Q000209:etiology