Postcholecystectomy syndrome

[Dorothey Allen]

Postcholecystectomy syndrome is occurrence of abdominal symptoms after cholecystectomy.
(See also Overview of Biliary Function.)
Postcholecystectomy syndrome occurs in 5 to 40% of patients. It refers to presumed gallbladder symptoms that continue or that develop after cholecystectomy, or to other symptoms that result from cholecystectomy. Removal of the gallbladder, the storage organ for bile, normally has few adverse effects on biliary tract function or pressures. In about 10% of patients, biliary colic appears to result from functional or structural abnormalities of the sphincter of Oddi, resulting in altered biliary pressures or heightened sensitivity.
The most common symptoms are dyspepsia or otherwise nonspecific symptoms rather than true biliary colic. Papillary stenosis, which is rare, is fibrotic narrowing around the sphincter, perhaps caused by trauma and inflammation due to pancreatitis, instrumentation (eg, endoscopic retrograde cholangiopancreatography), or prior passage of a stone. Other causes include a retained bile duct stone, pancreatitis, and gastroesophageal reflux.