The Diseased Cystic Duct Remnant

Cholecystectomy for chronically inflamed gallbladders with calculi provides an 85% to 90% satisfactory result. This high rate of amelioration in patients with chronic cholecystitis and cholelithiasis may be increased by the surgeon's technical "know how" in dissecting out the cystic duct to its junction with the common duct in preparation for total cholecystectomy. The purpose of this paper is to present a private practice series of cases of remnant cystic duct as a cause of postcholecystectomy symptoms and to review the literature on the subject. The first surgical approach to the removal of gallstones was performed by Bobbs1in 1867, when he did a cholecystotomy on a living patient. Since that time cholecystostomy has been used and nearly abandoned in favor of the more curative procedure of cholecystectomy. As this latter procedure was generally adopted an appreciable number of patients began to haunt their surgeon because of persistence or