<?xml version="1.0" encoding="utf-8"?><article>
	<front>
		<journal-meta>
			<journal-id journal-id-type="publisher">IJAR</journal-id>
			<journal-title>Indian Journal of Applied Research</journal-title>
			<issn pub-type="ppub">2249-555X</issn>
			<publisher>
				<publisher-name>Indian Society for Health and Advanced Research</publisher-name>
			</publisher>
		</journal-meta>
		<article-meta>
			<article-id pub-id-type="other">ijar-9-3-17149</article-id>
			<article-categories>
				<subj-group>
					<subject>Original Research Paper</subject>
				</subj-group>
			</article-categories>
			<title-group>
				<article-title>Incidence and management of cystic duct stones</article-title>
			</title-group>
			<contrib-group><contrib contrib-type="author">
						<name>
							<surname>Kumar</surname>
							<given-names>Garg</given-names>
							<prefix>Dr.</prefix>
						</name>
						<xref ref-type="aff" rid="aff000">
							<sup></sup>
						</xref>
						</contrib><contrib contrib-type="author">
						<name>
							<surname>Showkat</surname>
							<given-names>Nazir Wani</given-names>
							<prefix>Dr.</prefix>
						</name>
						<xref ref-type="aff" rid="aff002">
							<sup></sup>
						</xref>
						</contrib><contrib contrib-type="author">
						<name>
							<surname>Jashanpreet</surname>
							<given-names>K Virk</given-names>
							<prefix>Dr.</prefix>
						</name>
						<xref ref-type="aff" rid="aff004">
							<sup></sup>
						</xref>
						</contrib></contrib-group><pub-date pub-type="ppub">
				<month>March</month>
				<year>2019</year>
			</pub-date>
			<volume>9</volume>
			<issue>3</issue>
			<fpage>01</fpage>
			<lpage>02</lpage>
			<abstract>
				<title>ABSTRACT</title>
				<p>Background: laproscopic cholecystectomy represents a significant change in  the management of GB disease and is gold standard treatment for  symptomatic cholelithiasis. However some 15&ndash;20% of patients continue to  have postcholecystectomy syndromes, the causes of which are diverse. One  important such cause is cystic duct stones which are usually missed  intraopertively. Focused attention towards same with some intraoperative  maneuvers would help to reduce their contribution to PCS.
Methods: The study was carried over 3 years from 2014&ndash;2016 during which  743 LC were studied. Patients detected to have cystic duct stones by noting  abnormal bulge, adhesions or non uniformity of duct were subjected to  different intraoperative maneuvers like milking of duct, complete dissection  of CD&ndash;CBD junction and ligation of CD close to CBD were utilised Results: We found cystic duct stones in 87(11.7%) out of 743 Laproscopic cholecystectomies performed. Upon follow up we found that out of 87  patients of detected cystic duct stones, 84(96.5%) patients had no  complaints postoperatively upto 2 years while as 2(2.2%) patients had CBD  stones (both of them were patients of Mirriziâs syndrome) and one patient  had retained cystic duct stone even after milking of the stone to Gall bladder.
Conclusion: We conclude that the incidence of CD stones is underestimated  as well as under reported, which is a significant cause of PCS. However if  attention is given to CD during Laproscopic cholecystectomy and exploiting  some simple and safe maneuvers, they can be effectively dealt with reducing 
PCS.          
Methods: The study was carried over 3 years from 2014&ndash;2016 during which  743 LC were studied. Patients detected to have cystic duct stones by noting  abnormal bulge, adhesions or non uniformity of duct were subjected to  different intraoperative maneuvers like milking of duct, complete dissection  of CD&ndash;CBD junction and ligation of CD close to CBD were utilised
Results: We found cystic duct stones in 87(11.7%) out of 743 Laproscopic  cholecystectomies performed. Upon follow up we found that out of 87  patients of detected cystic duct stones, 84(96.5%) patients had no  complaints postoperatively upto 2 years while as 2(2.2%) patients had CBD  stones (both of them were patients of Mirriziâs syndrome) and one patient  had retained cystic duct stone even after milking of the stone to Gall bladder.
Conclusion: We conclude that the incidence of CD stones is underestimated  as well as under reported, which is a significant cause of PCS. However if  attention is given to CD during Laproscopic cholecystectomy and exploiting  some simple and safe maneuvers, they can be effectively dealt with reducing  PCS</p>
			</abstract>			
			<counts>
				<ref-count count="7"/>
				<page-count count="2"/>
			</counts>
		</article-meta>
	</front>
</article>