The cystic duct remnant syndrome refers to symptoms following cholecystectomy related to changes in the residual cystic duct.


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.


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