Remnant Gallbladder Cholecystitis After Subtotal Cholecystectomy: Management and Outcome.

Abstract

BackgroundSubtotal cholecystectomy (STC) is a viable alternative for challenging cases of severely acute or chronic inflammation of the gallbladder. However, despite its advantages, patients undergoing STC still face the risk of developing symptomatic gallstones in the remnant gallbladder. In such cases, redo resection of the gallbladder remnant is required, posing some technical challenges. In this report, we share our experience in diagnosing and surgical management of remnant gallbladder cholecystitis.MethodsA retrospective study of all patients admitted to a tertiary care hospital with symptoms directly linked to gallbladder remnant stones from 2018 to 2023 was performed.ResultsSix patients were admitted with symptoms directly linked to gallbladder remnant stones. The median age at presentation was 50 years (IQR 25-75), with median interval between the index surgery and the current presentation of 9.5 months (IQR 3-90). The presentation varied and included stump cholecystitis, cholangitis, Mirizzi syndrome, and liver abscess. All 6 patients underwent laparoscopic redo cholecystectomy, with 1 conversion to open surgery and without major complications. Symptoms resolved in all patients.ConclusionsSymptomatic gallstone disease in remnant gallbladder is rare and requires redo cholecystectomy. According to our limited series, laparoscopic redo cholecystectomy may be feasible and safe.