Cystic Duct Stump Measurement in Laparoscopic Cholecystectomy

Post-cholecystectomy syndrome refers to a wide spectrum of conditions that pose a challenging diagnostic dilemma. Cystic duct remnant, defined as a residual duct greater than 1 cm in length, may, in the presence of stones, cause post-cholecystectomy syndrome. Symptomatic patients often present with right upper quadrant pain, nausea, vomiting, and abnormal liver function tests, mimicking biliary colic. Diagnosis hinges on imaging modalities such as magnetic resonance cholangiopancreatography (MRCP) or endoscopic ultrasound (EUS), which can visualize the remnant and any contained calculi. While MRCP is non-invasive, EUS offers higher resolution and the potential for therapeutic intervention via endoscopic retrograde cholangiopancreatography (ERCP). Management strategies range from conservative approaches with pain management to definitive surgical or endoscopic removal of the remnant. Recurrent symptoms warrant thorough investigation to rule out other etiologies like sphincter of Oddi dysfunction or retained common bile duct stones. Surgical excision, either laparoscopically or via open approach, remains the gold standard, but endoscopic approaches, including ERCP with stone extraction or duct ablation, are increasingly utilized in selected cases, particularly in patients with high surgical risk. A careful and individualized approach is crucial to effectively manage this complex clinical entity. Cystic Duct Stump remnant measurement during Laparoscopic Cholecystectomy to leave smaller length of CD remnant may help in controling patient`s post operation symptomes.