ERCP is a highly effective and safe option for managing symptomatic cystic duct remnant stones in post-cholecystectomy patients, reducing the need for surgical excision.

• Technical success was achieved in 95% of cases (20/21), with clinical success at 91% (19/21).
• Balloon sweep alone cleared stones in 43% of patients, with cholangioscopy and electrohydraulic lithotripsy frequently required for larger or impacted stones.

Surgeons should consider ERCP as a first-line approach for this indication, as it may minimize invasive interventions.