What is remnant cystic duct?

What is remnant cystic duct?

Cystic duct remnant, defined as a residual duct greater than 1 cm in length, may, in the presence of stones, cause post-cholecystectomy syndrome. In this report, 4 patients with post-cholecystectomy syndrome due to cystic duct remnant are described.

What happens to cystic duct in cholecystectomy?

In open cholecystectomy, the cystic duct is ligated as close to the CBD as possible. Common reason for leaving a long cystic duct remnant is failure to identify the gall bladder-cystic junction. This is even more common in patients with acute cholecystitis.

What is cystic duct stump leak?

Bile leak is defined as a persistent leakage of bile into the peritoneal cavity or through the drain, if present. The main causes of bile leak include cystic duct stump leak (CDSL), injury to major bile ducts, injury to the duodenum or leaking from duct of Luschka.

What is cystic duct margin?

A positive cystic duct margin at index-cholecystectomy is a strong independent predictor of worse OS even if no further cancer is found at OER. In patients with positive cystic duct margin and no RC at OER common bile duct resection leads to improved outcomes.

Can gallbladder grow back after removal?

No, the gallbladder does not grow back. When it is removed, however, there is still a duct or tube that remains behind to drain bile from the liver to the intestine. It is in this duct that gallstones can form. Symptoms can be similar to your original gallbladder symptoms.

Is the cystic duct removed during gallbladder surgery?

A small incision is made just below the rib cage on the right side of the abdomen. The liver is moved to expose the gallbladder. The vessels and tubes (cystic duct and artery) to and from the gallbladder are cut and the gallbladder is removed.

How could you usually locate the cystic artery during cholecystectomy?

Proper recognition, ligation, and cut of the cystic duct and cystic artery with branches (dorsal and ventral) remain an integral condition for the removal of the gallbladder. Calot’s triangle, as an orientation structure, determines the most common location of the cystic artery.

How do you fix bile leak?

Bile leaks are a rare but serious complication of gallbladder surgery. If a bile duct is damaged during surgery, bile may leak into the abdominal cavity, causing extreme pain. Bile leaks are often corrected by placing a stent (narrow tube) in the duct to keep bile from escaping while the duct heals.

How do you treat a bile leak?

Bile leaks are usually treated by placing a temporary stent in the bile duct during an ERCP. During an ERCP your doctor places a thin, flexible tube down your esophagus, stomach and the first part of the small bowel to access the bile ducts. Your doctor will then place a stent to help improve the drainage of bile.

Where is cystic duct present?

The cystic duct connects the top of the gallbladder’s neck to the common hepatic duct. It then joins the common bile duct, which meets pancreatic duct before it empties into the duodenum. In the average adult, the cystic duct measures four centimeters in length.

What is unusual about the cystic duct?

Rare anomalies of the cystic duct include insertion into the right hepatic duct, double cystic ducts with or without a duplicated gallbladder, and absence of the cystic duct with the gallbladder emptying directly into the common bile duct (,13, ,14, ,18,,21–,23).

What does a dilated cystic duct look like on MRI?

Imaging anatomy. A cystic duct measuring > 5mm is considered abnormal (Dilated). The terminal end of the cystic duct remnant is described as resembling a “leaf bud” in normal post-cholecystectomy patients. When the remnant is pathologically dilated, it is described as having the appearance of a “flashlight bulb”.

What is the typical size of a remnant cystic duct remnant?

Imaging anatomy. Usually, a cystic duct remnant measuring 1-2 cm in length is left, although remnants can be seen up to 6 cm in length. Complications associated with the remnant cystic duct are retained stones in cystic duct, bile leakage, stricture, fistula formation, dilatation of the cystic duct remnant, amputation neuromas,…

What is cystic duct mucocele and how is it treated?

Cystic duct mucocele is a rare complication, where the remnant of the cystic duct is distended with mucus.[2] Following cholecystectomy, the cystic duct caliber in an asymptomatic patient is often the same as in a normal patient. The caliber of the normal remnant measures approximately 4 mm and the length is 5-25 mm.

What is the diameter of a cyst duct in cholecystectomy?

Cystic ducts shorter than 2 cm can also be found, which can present a significant challenge in the dissection and placement of clips during laparoscopic cholecystectomy. The diameter of the cyst duct ranges from 1 to 5 mm.