Cystic Duct Remnant Syndrome Following Cholecystectomy

 

Patient selection: post-cholecystectomy

 

The length of cystic duct remaining after cholecystectomy may range from 0.5 to 6 cm. The diameter is usually unchanged from normal (around 4 mm).

 

Clinical findings:

(1) persistent right upper quadrant abdominal pain or other symptoms

(2) variable dilation of the cystic duct remnant (> 5.0 mm in diameter) with a "flashlight bulb" like appearance

(3) exclusion of other explanations for the symptoms

 

Processes that may affect the cystic duct remnant:

(1) stone within the duct

(2) stricture

(3) bile leakage

(4) fistula

(5) dilatation with or without chronic inflammation

(6) amputation neuroma

(7) suture granuloma

(8) mucocele formation

 

The ultimate proof is resolution of findings following resection of the cystic duct remnant or correction of the defect.