title: Reformed gallbladder after laparoscopic subtotal cholecystectomy: correlation of surgical findings with ultrasound and CT imaging†.
abstract: Laparoscopic subtotal cholecystectomy is a technique that is becoming increasingly prevalent in modern surgery. It avoids the cystic duct and artery where acute or chronic cholecystitis prevents a safe laparoscopic dissection of these structures. There are numerous reports of symptomatic cystic duct remnants after subtotal cholecystectomy in the literature on post-cholecystectomy syndrome. We present a case report of a 62-year-old man who underwent emergent laparoscopic subtotal cholecystectomy complicated by the development of a persistent, controlled bile leak. This was followed on serial ultrasound examinations and managed with multiple drain insertions and endoscopic retrograde cholangiopancreatography. The patient represented 4 months later with right upper quadrant pain and was found to have an apparently normal gallbladder on CT abdomen. Repeat laparoscopic cholecystectomy demonstrated a reformed gallbladder wall and was completed in the standard fashion. This case demonstrates an unexpected complication of laparoscopic cholecystectomy with correlation of radiological and surgical findings.
authors: Department of Surgery, Gosford Hospital, Gosford, NSW, Australia suzanne.disano@gmail.com.
authors: Suzanne J
authors: SJ
authors: Di Sano
authors: Department of Surgery, Gosford Hospital, Gosford, NSW, Australia.
authors: Nicholas B
authors: NB
authors: Bull
references: Ann R Coll Surg Engl. 2009 Jan;91(1):25-9
references: 18990269
references: J Laparoendosc Surg. 1993 Aug;3(4):365-7
references: 8268507
references: J R Soc Med. 2002 Mar;95(3):138-9
references: 11872767
references: Surgery. 1985 Jul;98(1):1-6
references: 3892743
references: J R Coll Surg Edinb. 1995 Feb;40(1):20-1
references: 7738890
references: Surg Today. 2009;39(10):870-5
references: 19784726