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Concept: Cystic duct


This review summarizes recent innovations in the approaches to gallbladder disease, including laparoscopic cholecystectomy, cholecystectomy with natural orifice transluminal endoscopic surgery, percutaneous cholecystostomy, and peroral endoscopic gallbladder drainage.

Concepts: Surgery, Laparoscopic surgery, Gallbladder, Cholecystectomy, Endoscopic retrograde cholangiopancreatography, Endoscopy, Common hepatic duct, Cystic duct


: To investigate the risk of intestinal cancer in a cohort of people who had undergone cholecystectomy for gallstones, and in a cohort of people who had been hospitalized for gallbladder disease but had not undergone cholecystectomy.

Concepts: Epidemiology, Cancer, Actuarial science, Liver, Hepatology, Gallbladder, Common hepatic duct, Cystic duct


Calculi in the cystic duct remnant are one of the causes of postcholecystectomy syndrome. A 36-year-old woman presented thrice to the casualty department with right upper quadrant pain at an interval of 2 months every time. Ultrasound and CT scan of the abdomen was normal except for echoes in the gallbladder region may be clips. She was treated conservatively and discharged the first two times. The second time, the MR cholangiopancreatography was normal. She had undergone endoscopic retrograde cholangiopancreatography with sphincterotomy with stent in situ outside elsewhere before presenting to us for the third time, which was removed after 6-weeks. The third time, she was taken up for laparoscopic stump exploration, which revealed a stone, which was the cause of her pain. To conclude, stump stone can be a possibility of post cholecystectomy syndrome even after 6 years, and surgeons should be aware of it.

Concepts: Abdomen, Gallbladder, Cholecystectomy, Endoscopic retrograde cholangiopancreatography, Endoscopy, Magnetic resonance cholangiopancreatography, Cystic duct, Postcholecystectomy syndrome


Abstract The current rate of bile duct injury (BDI) after laparoscopic cholecystectomy is 0.4%, which is an unacceptable outcome. Several surgical approaches have been suggested to mitigate the occurrence of this dreaded complication. We propose a standardized approach, using Calot’s node as a critical anatomical landmark to guide gallbladder dissection and avoid BDI. We retrospectively analyzed a prospectively gathered database of 907 laparoscopic cholecystectomies using this standardized approach in our practice over a 5-year period. To date we have had no BDI and no cystic duct leak. Therefore, we suggest identification of Calot’s node as an additional method to avoid BDI during laparoscopic cholecystectomy.

Concepts: Hepatology, Bile, Bile duct, Laparoscopic surgery, Cholecystectomy, Gallstone, Common hepatic duct, Cystic duct


The optimal timing of cholecystectomy for patients admitted with acute gallbladder pathology is unclear. Some studies have shown that emergency cholecystectomy during the index admission can reduce length of hospital stay with similar rates of conversion to open surgery, complications and mortality compared with a ‘delayed’ operation following discharge. Others have reported that cholecystectomy during the index acute admission results in higher morbidity, extended length of stay and increased costs. This study examined the cost-effectiveness of emergency versus delayed cholecystectomy for acute benign gallbladder disease.

Concepts: Medical terms, Hospital, Surgery, Cultural studies, Laparoscopic surgery, Cholecystectomy, Common hepatic duct, Cystic duct


The aim was to describe the management of benign gallbladder disease and identify characteristics associated with all-cause 30-day readmissions and complications in a prospective population-based cohort.

Concepts: Cohort study, Epidemiology, Gallbladder, Common hepatic duct, Cystic duct


The aims of this prospective population-based cohort study were to identify the patient and hospital characteristics associated with emergency cholecystectomy, and the influences of these in determining variations between hospitals.

Concepts: Cohort study, Epidemiology, Patient, Hospital, Physician, Common hepatic duct, Cystic duct, Carl Czerny


Reports from US administrative databases showed an increase in cholecystectomy rate for functional gallbladder disorder (FGBD), a disease is not well recognized elsewhere. We aimed to identify the incidence and cholecystectomy rate for FGBD in an epidemiologically well-defined and prospectively studied population and compare results to published data.

Concepts: Epidemiology, Statistics, Demography, Gallbladder, Common hepatic duct, Cystic duct


The ideal management of common bile duct (CBD) stones associated with gall stones is a matter of debate. We planned a meta-analysis of randomized trials comparing single-stage laparoscopic CBD exploration and cholecystectomy (LCBDE) with two-stage preoperative endoscopic stone extraction followed by cholecystectomy (ERCP + LC).

Concepts: Hepatology, Bile duct, Cholecystectomy, Common bile duct, Gallstone, Common hepatic duct, Cystic duct, Choledocholithiasis


We aimed to present three new ultrasound signs-gallbladder scalloping, mammillated caudate lobe, and inferior vena cava scalloping-and determine their accuracy in diagnosing liver cirrhosis.

Concepts: Cirrhosis, Liver, Hepatology, Bilirubin, Hepatic portal vein, Inferior vena cava, Cystic duct, Falciform ligament