Laparoscopic Completion of Previous Open Subtotal Cholecystectomy

Symeonidis Dimitrios, MD, PhD, Kelemouridou Efthimia, MD, Koukoulis Georgios, MD, Kapsoritakis Andreas, MD, PhD, Tzovaras George, MD, PhD

Department of Surgery, University Hospital of Larissa, Biopolis, Larissa, Greece (Symeonidis D, Kelemouridou E, Koukoulis G, Tzovaras G). Department of Gatroenterology, University Hospital of Larissa, Biopolis, Larissa, Greece (Kapsoritakis A).

ABSTRACT

Introduction: The purpose of this study was to present a challenging case of laparoscopic completion cholecystectomy after a previous open subtotal cholecystectomy. A review of the relevant literature was conducted as well.

Case Description: A 64-year-old patient with a history of open cholecystectomy due to acute cholecystitis presented with right-upper-quadrant abdominal pain, fever, and deranged liver function tests. Magnetic resonance cholangiopancreatography revealed a gallbladder remnant with residual stones and a dilated common bile duct. The patient was submitted to an endoscopic retrograde cholangiopancreatography with sphincterotomy and common bile duct clearance. As symptoms persisted, the completion of the previous subtotal cholecystectomy was decided. A laparoscopic completion cholecystectomy was attempted and was completed successfully.

Discussion: Up to 10 cases of this certain sequence have been reported to date. Attempts for the laparoscopic removal of the gallbladder remnant should not be averted based on the history of open subtotal cholecystectomy.

Key Words: Completion cholecystectomy, Recurrent gallstones, Subtotal cholecystectomy.

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