Laparoscopic Remnant Cholecystectomy With CBD Exploration: A Tertiary Center Experience.

Background: After partial cholecystectomy, the remnant gallbladder can become symptomatic requiring surgical intervention. This study aims at assessing feasibility and safety of laparoscopic remnant cholecystectomy with common bile duct (CBD) exploration in patients having remnant gallbladder stones with choledocholithiasis.

Materials And Methods: This retrospective observational study includes data obtained over a period of 10 years, from 2010 to 2020, in 2 tertiary care centers performing advanced laparoscopic surgery. Patients with remnant gallbladder stones with choledocholithiasis were include in this study. All of them underwent laparoscopic remnant cholecystectomy with CBD exploration. Demographic, perioperative and follow up data were collected and analyzed.

Results: A total of 18 patients with a mean age of 47 years, male to female ratio of 1:3.5, with cholecystectomy done 10 months to 15 years back, were diagnosed with remnant gallbladder stones with choledocholithiasis during the period of 2010 to 2020. Five patients had undergone endoscopic retrograde cholangiopancreatography stenting of CBD 3 months to 2 years back. All of them underwent laparoscopic remnant cholecystectomy with CBD exploration. Trans cystic approach for CBD exploration was performed in 11 patients. In 7 patients, transductal CBD exploration was done, out of which, 1 patient needed T-tube placement. Median hospital stay was for 3 days. Morbidity rate was 5.56% at 30 days after operation. There was no recurrence of symptoms or mortality after a median follow up of 24 months (range: 5 to 60 mo).

Conclusion: Concurrent laparoscopic remnant cholecystectomy with CBD exploration is feasible, safe, and reproducible when performed in centers with experience in advanced laparoscopic surgery.