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  • 标题:Residual gall bladder: An emerging disease after safe cholecystectomy
  • 本地全文:下载
  • 作者:Gupta, Vikas ; Sharma, Anil Kumar ; Kumar, Pradeep
  • 期刊名称:Korean Journal of Hepato-Biliary-Pancreatic Surgery
  • 印刷版ISSN:1738-6349
  • 出版年度:2019
  • 卷号:23
  • 期号:4
  • 页码:353-358
  • DOI:10.14701/ahbps.2019.23.4.353
  • 出版社:by The Korean Association of Hepato-Biliary-Pancreatic Surgery
  • 摘要:Backgrounds/Aims

    Residual gallbladder mucosa left after subtotal/partial cholecystectomy is prone to develop recurrent lithiasis and become symptomatic, which mandates surgical removal. Methods

    We retrospectively evaluated the patients with residual gallbladder referred to us from January 2011 to December 2017. Based on MRCP we classified calot's anatomy to – type I where cystic duct was seen and type II where sessile GB stump was seen. Results

    21 patients with median age 38 years and M:F::1:9.5, had undergone cholecystectomy (3 months-20 years) prior, presented with recurrent biliary pain. 3 had jaundice (CBD stone, Mirizzi and biliary stricture), 1 had pancreatitis and one had malignancy of the GB. Imaging revealed type I anatomy in 14 (67%) and type II in 7 (33%). All underwent completion cholecystectomy – open in 18 and laparoscopic in 3 (one converted to open). Additional procedure was required in 5 patients – CBD exploration in 2 (10%) and one each Hepatico-jejunostomy, extended cholecystectomy and splenectomy. Median hospital stay was 1 day. There was no mortality and 10% morbidity. One patient with malignancy died at 2 years, two died of unrelated cause, one developed incisional hernia and the remaining were well at a median follow up of 29 months. Conclusions

    Residual GB lithiasis should be suspected if there are recurrent symptoms after cholecystectomy. MRCP based proposed classification can guide the management strategy. Completion cholecystectomy is curative.

  • 关键词:Gall bladder; Cholecystectomy; Residual; Cystic duct; Remnant; Recurrent
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