Postcholecystectomy syndrome: Difference between revisions

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==Pathophysiology==
==Pathophysiology==
Most often surgeries done laprascopically lead to trauma or remembrance of stone which are background players of cholecystectomy syndrome.These include bile leakage from an overlooked transection of normal or aberrant bile ducts, obstructive jaundice due to inadvertent ligation of the common duct or its postsurgical stricture, instrumentation injuries induced during biliary tract exploration, and the various types of biliary fistulas.<ref name="pmid9074919">{{cite journal| author=Ghahremani GG| title=Postsurgical biliary tract complications. | journal=Gastroenterologist | year= 1997 | volume= 5 | issue= 1 | pages= 46-57 | pmid=9074919 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9074919  }}</ref>


==Causes==
==Causes==
The causes can be due to bile duct injury, biliary leak, biliary fistula and retained bile duct stones. If untreated it can lead to include recurrent bile duct stones and bile duct strictures.<ref name="pmid19857610">{{cite journal| author=Jaunoo SS, Mohandas S, Almond LM| title=Postcholecystectomy syndrome (PCS). | journal=Int J Surg | year= 2010 | volume= 8 | issue= 1 | pages= 15-7 | pmid=19857610 | doi=10.1016/j.ijsu.2009.10.008 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19857610  }}</ref>


==Differentiating {{PAGENAME}} from Other Diseases==
==Differentiating {{PAGENAME}} from Other Diseases==
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===History and Symptoms===
===History and Symptoms===


 
Patient may present with abdominal pain, jaundice or dyspeptic symptoms.
===Physical Examination===
===Physical Examination===



Revision as of 16:56, 12 December 2017

Postcholecystectomy syndrome
ICD-10 K91.5
ICD-9 576.0

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List of terms related to Postcholecystectomy syndrome

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sunny Kumar MD [2]

Overview

The term Postcholecystectomy syndrome (PCS) describes the presence of abdominal symptoms after surgery to remove the gallbladder (Cholecystectomy). Symptoms include gastrointestinal distress and persistent pain in the upper right abdomen. [1]

Historical Perspective

In 1960, Freud M, gastroenterologist, surveyed 114 Postcholecystectomy patients and found 93% had pain, jaundice in 24% and 38% had fever.[2]

Classification

Pathophysiology

Most often surgeries done laprascopically lead to trauma or remembrance of stone which are background players of cholecystectomy syndrome.These include bile leakage from an overlooked transection of normal or aberrant bile ducts, obstructive jaundice due to inadvertent ligation of the common duct or its postsurgical stricture, instrumentation injuries induced during biliary tract exploration, and the various types of biliary fistulas.[3]

Causes

The causes can be due to bile duct injury, biliary leak, biliary fistula and retained bile duct stones. If untreated it can lead to include recurrent bile duct stones and bile duct strictures.[4]

Differentiating Postcholecystectomy syndrome from Other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications, and Prognosis

Natural History

Complications

Prognosis

Diagnosis

Diagnostic Criteria

History and Symptoms

Patient may present with abdominal pain, jaundice or dyspeptic symptoms.

Physical Examination

Laboratory Findings

 
 
 
 
 
 
 
 
 
 
 
 
Post cholecystectomy pain
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
History & Physical Examination
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Lab CBC LFT Serum amylase lipase
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Transabdominal ultrasound
TUS
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Normal TUS & LFT
 
TUS CBD>10mm &/or abnormal LFT
 
TUS with stones
 
Biloma
 
Abcess
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Workup for non-bilary causes
 
endoscopic US
 
ERCP
 
 
 
 
 
 
Percutenous drainage
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Workup for non-bilary causes
 
If stone:
removal of stone with sphincterotomy
If no stone:
manomatery with or without sphincterotomy
 
 
 
 
 
 

Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Prevention

References

  1. Womack, NA (1947). "The Persistence of Symptoms following Cholecystectomy". Annals of Surgery. 126: 31–55. Unknown parameter |coauthors= ignored (help)
  2. FREUD M, DJALDETTI M, DE VRIES A, LEFFKOWITZ M (1960). "Postcholecystectomy syndrome: a survey of 114 patients after biliary tract surgery". Gastroenterologia. 93: 288–93. PMID 13824916.
  3. Ghahremani GG (1997). "Postsurgical biliary tract complications". Gastroenterologist. 5 (1): 46–57. PMID 9074919.
  4. Jaunoo SS, Mohandas S, Almond LM (2010). "Postcholecystectomy syndrome (PCS)". Int J Surg. 8 (1): 15–7. doi:10.1016/j.ijsu.2009.10.008. PMID 19857610.

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