Endoscopy 2004; 36(3): 236-238
DOI: 10.1055/s-2004-814254
Case Report
© Georg Thieme Verlag Stuttgart · New York

Insufficient Cholecystectomy Diagnosed by Endoscopic Ultrasonography

H.  Hassan1 , P.  Vilmann1
  • 1Dept. of Surgical Gastroenterology D, Gentofte University Hospital, 2900 Hellerup, Denmark
Further Information

Publication History

Submitted 30 January 2003

Accepted after Revision 9 July 2003

Publication Date:
26 February 2004 (online)

Recurrent attacks of upper right quadrant pain after cholecystectomy are not infrequent. In most of these cases, the cause of the pain remains undiagnosed. Insufficient cholecystectomy has been described as a rare cause of post-cholecystectomy pain, although the true incidence is unknown. It is difficult to diagnose a residual gallbladder or a large cystic duct with residual stones, due to the size of the remaining structures. This report presents three patients who had experienced a long period of agonizing biliary-type pain after cholecystectomy. Abdominal ultrasound examinations, and magnetic resonance cholangiopancreatography (MRCP) in one patient, were normal. Endoscopic ultrasonography (EUS) demonstrated the presence of a small cystic structure with echogenic foci compatible with a residual gallbladder containing small gallstones. Two of the three diagnoses were confirmed by repeat surgery. EUS thus appears to be a valuable method for diagnosing insufficient cholecystectomy, and should be considered in patients with persistent pain attacks after cholecystectomy.

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H. Hassan, M. D.

Rødovrevej 200, 2. TH · 2610 Rødovre · Denmark

Email: hazim@dadlnet.dk

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