Ben Zvi Aviv, Dagan Amir, Freund Michael R, Yellinek Shlomo, Ben-Haim Menahem, Boaz Elad
Department of General Surgery, Sha'are Zedek Medical Center, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel.
Am Surg. 2025 Jun;91(6):1006-1009. doi: 10.1177/00031348251328493. Epub 2025 Mar 29.
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.
背景
胆囊次全切除术(STC)是处理胆囊严重急性或慢性炎症等具有挑战性病例的一种可行替代方法。然而,尽管它有诸多优点,但接受STC的患者仍面临在残余胆囊中形成有症状胆结石的风险。在这种情况下,需要再次切除残余胆囊,这带来了一些技术挑战。在本报告中,我们分享我们在诊断和手术治疗残余胆囊胆囊炎方面的经验。
方法
对2018年至2023年入住一家三级护理医院且症状与残余胆囊结石直接相关的所有患者进行回顾性研究。
结果
6例患者因与残余胆囊结石直接相关的症状入院。就诊时的中位年龄为50岁(四分位间距25 - 75),初次手术与此次就诊的中位间隔时间为9.5个月(四分位间距3 - 90)。临床表现多样,包括残端胆囊炎、胆管炎、Mirizzi综合征和肝脓肿。所有6例患者均接受了腹腔镜再次胆囊切除术,其中1例转为开放手术,且无重大并发症。所有患者症状均缓解。
结论
残余胆囊中有症状的胆结石疾病较为罕见,需要再次进行胆囊切除术。根据我们有限的病例系列,腹腔镜再次胆囊切除术可能是可行且安全的。