Surgical strategy modification upon intraoperative finding of cystic duct stones

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Carlos M. Canullán
Enrique J. Petracchi
Nicolás F. Baglietto
Adelina E. Coturel
Sebastián Di Summa
Bernabé M. Quesada
Juan E. Álvarez Rodríguez
Luis T. Chiappetta Porras


Background: laparoscopic cholecystectomy is the Gold Standard treatment for gallstone disease. To prevent bile duct injuries, most surgeons begin cystic duct dissection near the gallbladder. This usually leaves a long cystic duct stump. The incidence of cystic duct stones is 12.3-19% in Western series and 14.7% in Japan.
Objective: the aim of this study is to analyse cysctic duct stone prevalence and its relation with cho- ledocolithiasis.
Materials and methods: prospective non-randomized study, between January 2013 and December 2014.
Results: 387of 435 laparoscopic cholecystectomies were included for analysis. 62 cases (16%) had cystic duct stones, being significantly more frequent in non-complicated gallbladder disease and extrahepatic cholestasis. The presence of cystic duct stones correlated significantly with choledocolithiasis in non-complicated gallbladder disease and cholecystitis. Transcystic instrumentation was successful in 96% of these cases.
Conclusion: the finding of cystic duct stones during laparoscopic cholecystectomy could lead to a more difficult surgery mostly because the incidence of choledocolithiasis is higher. Transcystic instrumentation success rate is 96% in our series.


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Canullán, C. M., Petracchi, E. J., Baglietto, N. F., Coturel, A. E., Di Summa, S., Quesada, B. M., Álvarez Rodríguez, J. E., & Chiappetta Porras, L. T. (2021). Surgical strategy modification upon intraoperative finding of cystic duct stones. Revista Argentina De Cirugía, 109(3), 129–133. Retrieved from
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