Post-cholecystectomy syndrome

Post-cholecystectomy syndrome

Post-cholecystectomy syndrome is a recognised complication of cholecystectomies. Typically symptoms of dyspepsia, vomiting, pain, flatulence and diarrhoea occur in up to 40% patients post surgery.

The pathology behind the syndrome isn't completely clear, however there is some association with remnant stones and biliary injury. Pain is often due to sphincter of Oddi dysfunction and the development of surgical adhesions.

Management is often difficult, but often involves a low-fat diet and the introduction of bile acid sequestrants, such as Cholestyramine, to bind the excess bile acids and thus preventing lower gastrointestinal signs. Proton-pump inhibitors like Lansoprazole do play a role, if the patient is complaining of dyspeptic like symptoms. Antibiotics and pancreatic enzyme replacements play no part in management.

+PassMedicine Notes

Post-cholecystectomy syndrome is a recognised complication of cholecystectomies. Typically symptoms of dyspepsia, vomiting, pain, flatulence and diarrhoea occur in up to 40% patients post surgery.

The pathology behind the syndrome isn't completely clear, however there is some association with remnant stones and biliary injury. Pain is often due to sphincter of Oddi dysfunction and the development of surgical adhesions.

Management is often difficult, but often involves a low-fat diet and the introduction of bile acid sequestrants, such as Cholestyramine, to bind the excess bile acids and thus preventing lower gastrointestinal signs. Proton-pump inhibitors like Lansoprazole do play a role, if the patient is complaining of dyspeptic like symptoms. Antibiotics and pancreatic enzyme replacements play no part in management.