Background : Laparoscopic Cholecystectomy is one of the most commonly done surgical procedures and cystic stump stones are one of the causes of post-cholecystectomy syndromes. It can present with colicky pain, jaundice or cholangitis. It has an incidence of <2.5% in the published literature. The incidence of remnant cystic duct calculi after open cholecystectomy is as low as 0.02% whereas it is 4.19% in patients undergoing laparoscopic cholecystectomy.

Methods : A retrospective analysis was done for patients referred to tertiary care medical university with complaints of post-cholecystectomy syndromes from January to November 2023. Clinical data for patients operated for cystic duct stone patients (n=5) was analysed.

Results : Out of n=5 patients, n=3 of the patients underwent open and n=2 had undergone laparoscopic cholecystectomy in outside hospitals. Presenting complaints included on and off-right upper quadrant pain (60%) and obstructive jaundice (40%). Preoperative Magnetic resonance cholangiopancreatography (MRCP) of n=2 patients documented additional choledocholithiasis and 2/5 patients had a history of endoscopic retrograde cholangiopancreatography (ERCP) stenting with stent in situ. One patient underwent completion laparoscopic converted open cholecystectomy where gossypiboma was found, n=2 underwent laparoscopic completion cholecystectomy and n=2 underwent laparoscopic cholecystectomy with bile duct exploration. There was no mortality or post-operative complications in the 4-week follow-up.

Conclusions : Cystic stump stones are one of the post-cholecystectomy syndromes which are increasing due to the acceptance of subtotal cholecystectomy and emergency laparoscopic cholecystectomy. In our study, the patients presented had neither of the operative histories and contrary to the data, patients with a history of open cholecystectomy had cystic stump calculi.