Post-Cholecystectomy Syndrome

  • – Abdominal symptoms that resemble biliary pain following cholecystectomy
  • – Frequency after cholecystectomy: 5-40%
  • Common symptoms
  • – Dyspepsia
  • – Flatulence
  • – Bloating
  • – Persistent upper abdominal pain
  • – Jaundice
  • – Emesis
  • If symptoms occur early in the postoperative period : bile peritonitis secondary to iatrogenic biliary injury must be suspected

 

Causes of pain after cholecystectomy

  • 1. Biliary cause:
  • – Biliary stricture
  • – Choledocholithiasis
  • – Choledochocele
  • – Biliary malignancy
  • – SOD
  • – Cystic duct remnant
  • 2.Pancreatic cause
  • – Pancreatitis
  • – Pseudocyst
  • – Malignancy
  • 3.Other GI disorders
  • – GERD
  • – Intestinal malignancy
  • – IBS
  • – PUD
  • – Mesenteric ischemia
  • 4.Extra-intestinal disorders
  • – Coronary artery disease
  • – Intercostal neuritis
  • – Psychiatric disorder

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