Laparoscopic Completion Cholecystectomy and Common Bile Duct Exploration for Retained

Background: Recent enthusiasm in the surgical commu-nity for less invasive surgical approaches has resulted in widespread application of single-incision techniques. This has been most commonly applied in laparoscopic chole-cystectomy in general surgery. Cosmesis appears to be improved, but other advantages remain to be seen. Fea-sibility has been demonstrated, but there is little descrip-tion in the current literature regarding complications. Patient and Methods: We report the case of a patient who previously underwent single-incision laparoscopic cholecystectomy for symptomatic gallstone disease. After a brief symptom-free interval, she developed acute pan-creatitis. At evaluation, imaging results of ultrasonography and magnetic resonance cholangiopancreatography dem-onstrated a retained gallbladder with cholelithiasis. The patient was subsequently referred to our hospital, where she underwent further evaluation and surgical interven-tion. Results: Our patient underwent 4-port laparoscopic rem-nant cholecystectomy with transcystic common bile duct exploration. Operative exploration demonstrated a large remnant gallbladder and a partially obstructed cystic duct with many stones. Transcystic exploration with balloon extraction resulted in duct clearance. The procedure took 75 minutes, with minimal blood loss. The patient’s post-operative course was uneventful. Final pathology results demonstrated a remnant gallbladder with cholelithiasis and cholecystitis. Conclusion: This report is the first in the literature to describe successful laparoscopic remnant cholecystec-tomy and transcystic common bile duct exploration after previous single-port cholecystectomy. Although inadver-tent partial cholecystectomy is not unique to this tech-nique, single-port laparoscopic procedures may result in different and significant complications