Discussion

Partial subtotal cholecystectomy is performed to remove gallstones without dissecting a difficult

Calot's triangle due to severe inflammatory reaction thus avoiding an inadvertent bile duct injury.
Retained gallbladder after cholecystectomy can manifest with symptoms similar to those
experienced by the patient during the initial cholecystectomy. This symptom complex is referred
to as post cholecystectomy syndrome and usually presents as right upper quadrant pain and
dyspepsia without jaundice. This could either be due to retained stones or regeneration of stones
in the remnant gallbladder as well as the use of non absorbable sutures in contact with the
lumen of the biliary tree acting as a nidus for new stone formation. Rozces et al points to cystic
duct stump syndrome in 16% of patients as the cause of post cholecystectomy syndrome.
Treatment of gallbladder remnant with lithiasis is primarily surgical and can be approach safely
by laparoscopic means. The first laparoscopic completion cholecystectomy was reported by
Gurel et al in 1995. Chowbey et al in 2003 suggested that it is safe and feasible to remove the
gallbladder remnant through laparoscopic means.