DOI QR코드

DOI QR Code

Successful removal of remnant cystic duct stump stone using single-operator cholangioscopy-guided electrohydraulic lithotripsy: two case reports

  • Sung Hyeok Ryou (Department of Gastroenterology, Dankook University Hospital, Dankook University College of Medicine) ;
  • Hong Ja Kim (Department of Gastroenterology, Dankook University Hospital, Dankook University College of Medicine)
  • Received : 2021.11.04
  • Accepted : 2022.01.30
  • Published : 2023.05.30

Abstract

Cholecystectomy is the best method for treating gallstone diseases. However, 10%-30% of patients who undergo a cholecystectomy continue to complain of upper abdominal pain, dyspepsia, or jaundice-this is referred to as postcholecystectomy syndrome. Cystic duct stump stones are a troublesome cause of postcholecystectomy syndrome. Conventionally, surgery is mainly performed to remove cystic duct stump stones. However, repeated surgery can cause complications, such as postoperative bleeding, biliary injury, and wound infection. As an alternative method of surgery, endoscopic retrograde cholangiopancreatography is sometimes used to remove cystic duct stump stones, although the success rate is not high due to technical difficulties. Recently, peroral cholangioscopy, which can directly observe the bile duct, has been suggested as an alternative method. We report two cases in which a cystic duct stump stone was successfully removed via a single-operator cholangioscopy, after failure with an endoscopic retrograde cholangiopancreatography.

Keywords

References

  1. El Nakeeb A, Ezzat H, Askar W, et al. Management of residual gallbladder and cystic duct stump stone after cholecystectomy: a retrospective study. Egyptian J Surg 2016;35:391-397.
  2. Schofer JM. Biliary causes of postcholecystectomy syndrome. J Emerg Med 2010;39:406-410.
  3. Walsh RM, Ponsky JL, Dumot J. Retained gallbladder/cystic duct remnant calculi as a cause of postcholecystectomy pain. Surg Endosc 2002;16:981-984.
  4. Palanivelu C, Rangarajan M, Jategaonkar PA, et al. Laparoscopic management of remnant cystic duct calculi: a retrospective study. Ann R Coll Surg Engl 2009;91:25-29.
  5. Mageed SA, Omar MA, Redwan AA. Remnant gallbladder and cystic duct stump stone after cholecystectomy: tertiary multicenter experience. Int Surg J 2018;5:3478-3483.
  6. Issa H, Bseiso B, Almousa F, et al. Successful treatment of Mirizzi's syndrome using SpyGlass guided laser lithotripsy. Gastroenterology Res 2012;5:162-166.
  7. Shirah BH, Shirah HA, Zafar SH, et al. Clinical patterns of postcholecystectomy syndrome. Ann Hepatobiliary Pancreat Surg 2018;22:52-57.
  8. Rieger R, Wayand W. Gallbladder remnant after laparoscopic cholecystectomy. Surg Endosc 1995;9:844.
  9. Rozsos I, Magyarodi Z, Orban P. Cystic duct syndrome and minimally invasive surgery. Orv Hetil 1997;138:2397-2401.
  10. Parmar AK, Khandelwal RG, Mathew MJ, et al. Laparoscopic completion cholecystectomy: a retrospective study of 40 cases. Asian J Endosc Surg 2013;6:96-99.
  11. Kim JY, Kim KW, Ahn CS, et al. Spectrum of biliary and nonbiliary complications after laparoscopic cholecystectomy: radiologic findings. AJR Am J Roentgenol 2008;191:783-789.
  12. Rozsos I, Magyarodi Z, Orban P. The removal of cystic duct and gallbladder remnant by microlaparotomy. Acta Chir Hung 1997;36:297-298.
  13. Kar A, Gulati S, Mohammed S, et al. Surgical management of cystic duct stump stone or gallbladder remnant stone. Indian J Surg 2018;80:284-287.
  14. England RE, Martin DF. Endoscopic management of Mirizzi's syndrome. Gut 1997;40:272-276.
  15. Ghersi S, Fuccio L, Bassi M, et al. Current status of peroral cholangioscopy in biliary tract diseases. World J Gastrointest Endosc 2015;7:510-517.
  16. Franzini TA, Moura RN, de Moura EG. Advances in therapeutic cholangioscopy. Gastroenterol Res Pract 2016;2016:5249152.
  17. Seelhoff A, Schumacher B, Neuhaus H. Single operator peroral cholangioscopic guided therapy of bile duct stones. J Hepatobiliary Pancreat Sci 2011;18:346-349.
  18. Sandha J, van Zanten SV, Sandha G. The safety and efficacy of single-operator cholangioscopy in the treatment of difficult common bile duct stones after failed conventional ERCP. J Can Assoc Gastroenterol 2018;1:181-190.