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March 15, 1958


JAMA. 1958;166(11):1363-1366. doi:10.1001/jama.1958.62990110014023

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Incomplete gallbladder surgery usually results from poor exposure, poor anesthesia, misconception of the surgical anatomy, and/or an attempt to perform a cholecystectomy in the presence of a fulminating acute cholecystitis. The differential diagnosis of incomplete cholecystectomy includes overlooked stones in the cystic or common ducts, spasm of the sphincter of Oddi, subacute and chronic pancreatitis, and, oddly enough, esophageal hiatus hernia. Symptoms are likely to recur if a pathological gallbladder is not removed completely.

The complaints of such a patient closely resemble those which were present prior to the cholecystectomy. That portion of the gallbladder which the surgeon may fail to remove is Hartmann's pouch (infundibulum). The latter is not to be confused with a cystic duct remnant. The human gallbladder does not have the ability to regenerate. One wonders if many so-called "cystic duct syndromes" or "post cholecystectomy syndromes" are not in reality incomplete cholecystectomies. Amputation neuromas along the

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