Post-cholecystectomy syndrome secondary to choledocholithiasis and remnant gallbladder: case report

Abstract

Cholecystectomy is considered a gold standard treatment for symptomatic gallstones. Despite surgical treatment, up to 15% of patients may persist or develop new symptoms described as a post-cholecystectomy syndrome (PCS). Among the biliary causes of this condition, we can rarely observe the appearance of gallbladder and/or remaining cystic duct. This paper describes a 54-year-old woman with history of conventional cholecystectomy 7 years ago, complaining of fecal acholia, jaundice, fever, pain in the right hypochondrium for 1 month. During the investigation, imaging exams showed findings suggestives of obstructive choledocholithiasis and by performing an Endoscopic Retrograde Cholangiopancreatography was also identified the presence of a neogallbladder. In view of the findings, the patient was diagnosed with PCS secondary to choledocholithiasis and guided to a surgical approach through open cholecystectomy. Therefore, one can observe the importance of timely identification of PCS in these patients, knowing it’s causes and mastering it’s management.