Ivan Adamovic*, Kostas Michael, Tim Stegemann, Maurus Murer, Alexander Golowan, Hans-Dieter Mäder and Lukas Krähenbühl
Background: Incomplete resection of the gallbladder is not as low as previously thought and occurs in up to 16% of operated patients. In some of these patients, symptoms may persist after surgery. These include upper abdominal pain, fever, dyspepsia, and jaundice. After diagnosis, surgical intervention is necessary to alleviate symptoms and avoid potential complications such as recurrent cholangitis with potential sepsis, Mirizzi syndrome, pancreatitis, or carcinoma.
Case presentation: The patient was a 53-year-old man with previous laparoscopic cholecystectomy in 2002 for acute cholecystitis and postoperatively several years of episodes of upper abdominal pain, discomfort, and dyspepsia. In December 2023, he was hospitalized for a few days due to upper abdominal pain and cholangitis. MRCP revealed no evidence of intra- or extrahepatic cholestasis and showed clipping artifacts in the area of the elongated ductus cysticus remnant of 3 cm. Laparoscopic remnant cystic duct resection was performed without complications. Follow-up has been done for 6 months, and so far, the patient has no symptoms or complaints.
Conclusion: Cystic Duct Remnant Syndrome is more common than previously thought. MRCP should be the gold standard for patients with suspected Cystic Duct Remnant Syndrome. Laparoscopic surgery and resection of the cystic duct remnant are necessary, safe, and successful operations.
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