World Library  
Flag as Inappropriate
Email this Article

Postcholecystectomy syndrome

Article Id: WHEBN0006038307
Reproduction Date:

Title: Postcholecystectomy syndrome  
Author: World Heritage Encyclopedia
Language: English
Subject: Sphincter of Oddi dysfunction, Grynfeltt-Lesshaft hernia, Gastrojejunocolic fistula, Ileitis, Gastric volvulus
Publisher: World Heritage Encyclopedia

Postcholecystectomy syndrome

Postcholecystectomy syndrome
Classification and external resources
ICD-10 K91.5
ICD-9-CM 576.0

Postcholecystectomy syndrome (PCS) describes the presence of abdominal symptoms after surgical removal of the gallbladder (cholecystectomy).

Symptoms of postcholecystectomy syndrome may include:

  • Upset stomach, nausea, and vomiting.
  • Gas, bloating, and diarrhea.
  • Persistent pain in the upper right abdomen.[1]

Symptoms occur in about 5 to 40 percent of patients who undergo cholecystectomy,[2] and can be transient, persistent or lifelong.[3][4]

The pain associated with postcholecystectomy syndrome is usually ascribed to either sphincter of Oddi dysfunction or to post-surgical adhesions.[5] A recent study[6] shows that postcholecystectomy syndrome can be caused by biliary microlithiasis.

Approximately 50% of cases are due to biliary causes such as remaining stone, biliary injury, dysmotility, and choledococyst. The remaining 50% are due to non-biliary causes. This is because upper abdominal pain and gallstones are both common but are not always related.

Chronic diarrhea in postcholecystectomy syndrome is a type of bile acid diarrhea (type 3).[4] This can be treated with a bile acid sequestrant like cholestyramine[7][3] or colesevelam,[8][9] which may be better tolerated.[10]


  • Ultrasound of the abdominal cavity.
  • General and biochemical blood.
  • Intravenous cholangiography.
  • Esophagogastroduodenoscopy for examination of the stomach, duodenum and the area major duodenal papilla.
  • Retrograde cholangiopancreatography.
  • Analysis of biliary sludge obtained through endoscopic retrograde cholangiopancreatography (ERCP)


Some individuals may benefit from diet modification, such as a reduced fat diet, following cholecystectomy. The liver produces bile and the gallbladder acts as reservoir. From the gallbladder, bile enters the intestine in individual portions. In the absence of gallbladder, bile enters the intestine constantly, but in small quantities. Thus, it may be insufficient for digestion of fatty foods. Postcholecystectomy syndrome treatment depends on the identified violations that led to it. Typically, the patient is recommended dietary restriction table with fatty foods, enzyme preparations, antispasmodics, sometimes cholagogue.[11]

If the pain is caused by biliary microlithiasis, oral ursodeoxycholic acid can alleviate the condition.[6]


  1. ^
  2. ^
  3. ^ a b
  4. ^ a b
  5. ^
  6. ^ a b
  7. ^
  8. ^
  9. ^
  10. ^
  11. ^
This article was sourced from Creative Commons Attribution-ShareAlike License; additional terms may apply. World Heritage Encyclopedia content is assembled from numerous content providers, Open Access Publishing, and in compliance with The Fair Access to Science and Technology Research Act (FASTR), Wikimedia Foundation, Inc., Public Library of Science, The Encyclopedia of Life, Open Book Publishers (OBP), PubMed, U.S. National Library of Medicine, National Center for Biotechnology Information, U.S. National Library of Medicine, National Institutes of Health (NIH), U.S. Department of Health & Human Services, and, which sources content from all federal, state, local, tribal, and territorial government publication portals (.gov, .mil, .edu). Funding for and content contributors is made possible from the U.S. Congress, E-Government Act of 2002.
Crowd sourced content that is contributed to World Heritage Encyclopedia is peer reviewed and edited by our editorial staff to ensure quality scholarly research articles.
By using this site, you agree to the Terms of Use and Privacy Policy. World Heritage Encyclopedia™ is a registered trademark of the World Public Library Association, a non-profit organization.

Copyright © World Library Foundation. All rights reserved. eBooks from Project Gutenberg are sponsored by the World Library Foundation,
a 501c(4) Member's Support Non-Profit Organization, and is NOT affiliated with any governmental agency or department.