True about cystic duct stump stone are all except

Postcholecystectomy syndrome The remnant of the cystic duct or gallbladder (in subtotal cholecystectomy) has historically been implicated as the source of pain, nausea and vomiting in postcholecystectomy patients An increase in Choledochal pressure resulting in cystic stump distension, inflammation or stone obstruction within the remnant of the cystic duct or gallbladder, and an increase in the sphincter of oddi pressure have all served as causes of postcholecystectomy problems However, various studies have confirmed that symptomatic improvement only occurs when a stone is present in the CBD or cystic duct and is subsequently removed endoscopically or operative reintervention In general, persistent symptoms following a cholecystectomy in which no cholangiogram was performed warrants analysis of the liver function profile and/or noninvasive imaging with either ultrasound or MRCP to assess for retained stone If CBD stone are present, Therapeutic ERCP is suggested Ref: Sabiston 20th edition Pgno : 1501-1504