The so-called “Postcholecystectomy Syndrome” may be due to various pathological biliary causes. Theaim of this study was to evaluate the significance of the cystic duct stump syndrome and if so, how often along (>1.5 cm) cystic duct stump was an indication for reoperation on the bile ducts after cholecystectomyin our patients. Three hundred and twenty two patients underwent a second operation on the bileducts after cholecystectomy in the last ten years. In 35 patients (10.8%) a striking finding was a longcystic duct stump (>1.5 cm). In 24 of these patients, a pathological finding, in addition to the long cysticduct stump, was found on exploration. Out of these 24 patients there were 14 with common bile ductstones; 6 with stenosis of the sphincter of Oddi; 3 with chronic pancreatitis and in one patient hepatitiswas the cause of the symptoms. From the remaining 11 patients 8 had a stone in a partial gall bladder orcystic duct stump. One patient had a fistula between the cystic duct stump and duodenum and one asuture granuloma. There was only one patient where a 1.5 cm long cystic duct stump remnant was theonly pathological finding. Four years after reoperation this patient is still suffering from the sameintermittent gastrointestinal symptoms. We conclude that the cystic duct stump is hardly ever a cause forrecurrent symptoms in itself. Total excision of the cystic duct does not eliminate the existence ofpostcholecystectomy symptoms.
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