Endoscopic retrograde cholangiopancreatography (ERCP) offers a highly successful and safe alternative for managing symptomatic cystic duct remnant (CDR) stones in postcholecystectomy syndrome, achieving 95% technical success.

• Out of 21 patients, clinical success was 91%, with balloon sweeps clearing 43% of stones.
• Cholangioscopy was necessary for 43% of cases, and electrohydraulic lithotripsy was used in 89% of those.

Surgeons should consider ERCP for CDR stones, particularly for patients with large or impacted stones, while being mindful of the potential for mild pancreatitis in about 10% of cases.