Post-Cholecystectomy Gall Bladder Remnant and Cystic Duct Stump stone: surgical pitfalls, causes of occurrence and completion cholecystectomy (open versus laparoscopic) as a safe surgical option of treatment: short and long term outcome. Randomized Controlled Clinical Trials.

Abstract

Introduction : cholecystectomy is the standard surgical option of symptomatic gallbladder disease. The symptoms persist after cholecystectomy in 10 - 20% of cases. Residual gall bladder/cystic duct stump stone is one of the most important cause. Aim : to compare between open and laparoscopic completion cholecystectomy for gall bladder (GB) remnant and cystic duct stump stones as regard short and long term outcome.Methods : This study was conducted on 84 cases with residual GB/cystic duct stump stone that were divided into 2 groups, the open completion cholecystectomy group and the laparoscopic completion cholecystectomy group. The diagnosis was made by ultrasound and magnetic resonance cholangio-pancreatography.Results : The mean operative time was 120±13 minutes in open group and 160±10 in laparoscopic group. Blood loss occurred in 8 cases in open group and 2 cases in laparoscopic group that necessitated blood transfusion. Biliary injuries detected intraoperative occurred in 3 cases with open approach and 2 cases with laparoscopic approach and suture immediately by vicryl 3/0. The mean hospital stay was shorter in laparoscopic group than open group. .Conclusion : laparoscopic Completion cholecystectomy is a safe surgical approach for cystic duct stump stone.Research question: is laparoscopic completion cholecystectomy is safe in managing gall bladder and cystic duct stump stones?Hypothesis: laparoscopic completion cholecystectomy is safe in managing gall bladder and cystic duct stump stones.All ethical approval was given by our local Faculty of Medicine ethical committee.Registration at clinicaltrials.gov protocol registration quality control review criteria: NCT04329143 registered in 31 March 2020.retrospective registeredThe work described has been carried out in accordance with The Code of Ethics of the World Medical Association (Declaration of Helsinki) for experiments involving humans.