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Journal of Case Reports
Symptomatic Residual Gallbladder: A Rare Condition Associated to Subtotal Cholecystectomy: A Report of Two Cases
Rafaela Capelli1,2,5, Klaus Steinbrück3,5, Luiza Basilio2,5, Marcelo D’Oliveira2,5, Renato Cano2,5, Hanna Vasconcelos2,5, Reinaldo Fernandes3,4,5, Marcelo Enne2,5
1Department of Surgical Gastroenterology, Federal University of São Paulo, São Paulo, Brazil; 2Hepatobiliary Surgery Unit, Ipanema Federal Hospital, Rio de Janeiro, Brazil; 3Hepatobiliary Surgery Unit, Bonsucesso Federal Hospital, Rio de Janeiro, Brazil; 4Department of General Surgery, Fluminense Federal University, Brazil; 5Hepatobiliary Multidisciplinary Group, Rio de Janeiro, Brazil.
Corresponding Author:
Dr Klaus Steinbrück
Email: steinbruck@gmail.com
Received: 21-MAY-2021 Accepted: 24-NOV-2021 Published Online: 30-DEC-2021
DOI: http://dx.doi.org/10.17659/01.2021.0063
Background: Residual gallbladder is the remnant part of the gallbladder not resected during subtotal cholecystectomy. This technique is used mostly in cholecystitis cases, to avoid biliary injury. In some patients, the residual gallbladder may become symptomatic causing symptoms related to gallstone problems, such as symptomatic cholelithiasis, choledocholithiasis and gallstone pancreatitis. Case Report: Herein, we describe the two patients, a 52-year-old man and a 67-year-old woman, respectively submitted to cholecystectomy 16 months and 24 years before, who presented mainly abdominal pain after eating. Abdominal ultrasonography identified the remnant gallbladder in the first case. Second patient was wrongly treated for gastritis for one year, until residual gallbladder was confirmed by magnetic resonance cholangio-pancreatography. Patients underwent surgical treatment, with good results. Conclusion: Symptomatic residual gallbladder should be suspected in patients previously submitted to cholecystectomy, presenting symptoms suggestive of biliary colic. Symptoms may arise many years after the index surgery. Since this is a rare condition, a high grade of suspicion is required and imaging exams are important to confirm diagnosis. Caution is necessary during surgery, due to adhesions to the hepatic pedicle and common bile duct injury risk.
Keywords : Cholecystectomy, Gallbladder, Magnetic Resonance Cholangio-pancreatography, Post-Cholecystectomy Syndrome.
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