Abstract
The postcholecystectomy syndrome refers to the persistence of gastrointestinal symptoms after cholecystectomy; patients with this syndrome commonly seek treatment in the Emergency Department (ED). There are a multitude of biliary and non-biliary causes of postcholecystectomy syndrome. To review the biliary causes of postcholecystectomy syndrome and present a suggested diagnostic workup. A number of biliary causes are discussed, including choledocholithiasis, bile duct injury and biliary leaks, cystic duct and gallbladder remnants, sphincter of Oddi dysfunction, and biliary ascariasis. The ED workup should focus on differentiating biliary from non-biliary causes of the patient's symptoms. A right upper quadrant abdominal ultrasound, liver transaminases, alkaline phosphatase, and serum bilirubin are the tests most useful in the ED for making this distinction and determining the most appropriate treatment and disposition of the patient. Computed tomography may be of use in the initial post-operative period.
References
Nov 1, 1993·Gastrointestinal Endoscopy·P RolnyW J Hogan
Mar 17, 2004·Digestive Surgery·Omar Javed ShahShowkat A Zargar
Jan 12, 2005·Clinical Radiology·O A TerhaarM J Lee
Apr 2, 2005·Current Gastroenterology Reports·James Toouli
Dec 13, 2005·Scandinavian Journal of Gastroenterology·Thue BisgaardHenrik Kehlet
Jan 25, 2006·The British Journal of Surgery·S Connor, O J Garden
Citations
May 6, 2009·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Luigi Maria Pernice, Francesco Andreoli
Jun 1, 2010·The Indian Journal of Surgery·Pradeep ChowbeyManish Baijal
Mar 26, 2010·The British Journal of Radiology·R GiromettiC Zuiani
Dec 2, 2015·Journal of Minimal Access Surgery·Pradeep ChowbeyRajesh Khullar
Jun 9, 2015·PloS One·Ming-Chieh TsaiCha-Ze Lee
Nov 30, 2016·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Deepa MaggeHerbert J Zeh
Apr 25, 2014·Acta Cirúrgica Brasileira·Fu LiGui-yang Wang
May 13, 2017·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Jing ZhangXu-Feng Zhang
Jan 31, 2018·The Indian Journal of Radiology & Imaging·Binit Sureka, Amar Mukund
Oct 27, 2017·Journal of Minimal Access Surgery·Divya AroraAtul Sachdev
Mar 2, 2019·Journal of Hepato-biliary-pancreatic Sciences·Julie G GrossmanWilliam G Hawkins
Aug 30, 2017·Scandinavian Journal of Gastroenterology·Maria Teresa HowieJohanna Österberg
Aug 6, 2013·Revista do Colégio Brasileiro de Cirurgiões·Hunaldo Lima de MenezesMelissa Ramos Reis
Aug 9, 2019·Medicine·Zihan YinFanrong Liang
Mar 15, 2018·Annals of Hepato-biliary-pancreatic Surgery·Bader Hamza ShirahKhalid B Albeladi
Oct 27, 2018·BJR Case Reports·Priyank S Chatra
Jul 18, 2020·Proceedings·Cindy NgSamuel N Forjuoh
May 22, 2019·Gastroenterology Research and Practice·Carmen S S LatensteinPhilip R de Reuver
Nov 17, 2020·Case Reports in Medicine·Michael SimonDavid Wilson
May 15, 2021·International Journal of Surgery Case Reports·Wafa Ben HmidaRamzi Nouira