{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T15:48:25Z","timestamp":1792165705505,"version":"4.4.0"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Remnant gall bladder and cystic duct stump calculi are uncommon but significant causes of post-cholecystectomy syndrome, often presenting after a prolonged interval and posing diagnostic and technical challenges. Evidence from contemporary Indian cohorts remains limited and heterogeneous.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods:<\/jats:title>\n                    <jats:p>This retrospective observational study analysed 22 consecutive patients who underwent completion cholecystectomy for symptomatic remnant gall bladder or cystic duct stump calculi between January 2015 and December 2024 at a tertiary referral centre. Patients with radiologically confirmed remnant pathology and prior sub-total or difficult cholecystectomy were included. Clinical, imaging, operative, perioperative and follow-up outcomes were analysed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The mean age was 47.8 years with female predominance (77.2%). The median interval between index surgery and symptom onset was 4 years. Biliary colic was the most common presentation (86.4%), with complications in 18.2% of patients. Ultrasonography detected pathology in 76%, whereas magnetic resonance cholangiopancreatography (MRCP) demonstrated 100% diagnostic accuracy. Laparoscopic completion cholecystectomy was successfully performed in 86.4% of patients, with a conversion rate of 9%. The mean operative duration was 118 min, and the mean blood loss was 87 ml. Critical view of safety was achieved in 50% of cases. Post-operative complications (Clavien\u2013Dindo &gt;II) occurred in 13.6% of patients, with no mortality. The median hospital stay was 2 days. At a median follow-up of 26 months, all patients achieved complete relief of biliary pain, although 35% of patients reported mild dyspeptic symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Completion cholecystectomy is a safe and effective definitive treatment for remnant gall bladder and cystic duct stump calculi, with high laparoscopic feasibility and favourable outcomes in experienced hands. MRCP plays a crucial role in diagnosis and operative planning, while redo surgery remains technically demanding due to altered anatomy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jmas.jmas_234_26","type":"journal-article","created":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T15:00:14Z","timestamp":1792162814000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Completion cholecystectomy for remnant gall bladder stones: A tertiary centre experience"],"prefix":"10.4103","author":[{"given":"Mohammed","family":"Motiwala","sequence":"first","affiliation":[{"name":"Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Devender","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, 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