Colecistitis del remanente vesicular, una entidad en incremento: reporte de un caso

BACKGROUND: Subtotal cholecystectomy was described in 1985 as an alternative to total cholecystectomy in cases of difficult cholecystectomy. It was classified as reconstituted and fenestrated subtotal. In spite of being a viable alternative, up to 10.6% of biliary leakage is reported and 2.2% of patients present with cholecystitis of the gallbladder remnant. The objective of this report is to describe and emphasize the importance of an adequate diagnosis of complications in patients with a history of subtotal cholecystectomy. CLINICAL CASE: 72-year-old male with a history of open subtotal cholecystectomy 6 years prior to his admission to the emergency department due to right hypochondrium pain and vomiting. He had a history of biliary pancreatitis and choledocholithiasis after subtotal cholecystectomy resolved by endoscopic retrograde cholangiopancreatography (ERCP). It was decided to admit the patient and a diagnosis of cholecystitis of the gallbladder remnant was made. Laparoscopic cholecystectomy of the remnant was performed with subsequent clinical resolution. CONCLUSIONS: Although subtotal cholecystectomy may be the only option in cases of difficult cholecystectomy, it may result in future complications. The possibility of more complex surgical reinterventions should be considered. Our case report demonstrates that total cholecystectomy in cases of cholecystitis should be performed whenever possible to avoid potential complications caused by subtotal cholecystectomy.