Sahoo Manash Ranjan, Kumar Anil
Department of General Surgery, S.C.B. Medical College, Cuttack, Odisha, India.
BMJ Case Rep. 2013 Feb 1;2013:bcr2012007957. doi: 10.1136/bcr-2012-007957.
Calculi in the cystic duct remnant are one of the causes of postcholecystectomy syndrome. A 36-year-old woman presented thrice to the casualty department with right upper quadrant pain at an interval of 2 months every time. Ultrasound and CT scan of the abdomen was normal except for echoes in the gallbladder region may be clips. She was treated conservatively and discharged the first two times. The second time, the MR cholangiopancreatography was normal. She had undergone endoscopic retrograde cholangiopancreatography with sphincterotomy with stent in situ outside elsewhere before presenting to us for the third time, which was removed after 6-weeks. The third time, she was taken up for laparoscopic stump exploration, which revealed a stone, which was the cause of her pain. To conclude, stump stone can be a possibility of post cholecystectomy syndrome even after 6 years, and surgeons should be aware of it.
胆囊管残端结石是胆囊切除术后综合征的病因之一。一名36岁女性曾3次前往急诊科，每次间隔2个月，均出现右上腹疼痛。腹部超声和CT扫描均正常，胆囊区域的回声可能为夹子。前两次她接受了保守治疗并出院。第二次，磁共振胰胆管造影正常。她在第三次来我院就诊前，曾在其他地方接受过内镜逆行胰胆管造影术及括约肌切开术并原位放置支架，6周后取出。第三次，她接受了腹腔镜残端探查，发现一枚结石，这就是她疼痛的原因。总之，即使在6年后，残端结石也可能是胆囊切除术后综合征的病因之一，外科医生应予以重视。
