Clinical characteristics and treatment approaches in patients with post-cholecystectomy syndrome due to remnant gallbladder

Abstract

Aim: A remnant gallbladder is a rare problem encountered in the diagnosis and treatment of the post-cholecystectomy syndrome.This study aimed to evaluate the clinical features and treatment modalities of patients with a symptomatic remnant gallbladder aftercholecystectomy.Material and Methods: The data of 11 patients who were operated following the diagnosis of a remnant gallbladder between January2013 and January 2019 were evaluated retrospectively. Clinical characteristics, diagnosis and treatment management, laparoscopyto open conversion rate and hospital stay were evaluated.Results: The median age was 55.3 years (range, 36 to 77 years), and the male/female ratio was 1/10. Right upper quadrant pain andjaundice were the most common symptoms. The time interval between cholecystectomy and symptom recurrence was 46.8 (range,1 to 420) months. A remnant gallbladder was determined by ultrasonography in seven patients (63.6%) and by magnetic resonancecholangiopancreatography in 11 patients (100%). Preoperatively, ERCP was performed in six patients due to suspicion of stones inthe main bile duct, except for the remnant gallbladder. Complementary cholecystectomy was performed by laparoscopically in sevenpatients, and only four patients had a conversion to open surgery. The median duration of hospital stay was four days (range, 2 to9 days).Conclusion: The remnant gallbladder, which is the rare and a cause of the post-cholecystectomy syndrome, is a pathology thatshould be considered in patients with postoperative symptoms. Patients with a symptomatic remnant gallbladder should be treatedwith a multidisciplinary approach, including a careful choice of imaging modalities and surgical or endoscopic treatment methods.