Intolerance to a fatty diet is one of the conditions of postcholecystectomy syndrome (PCS), a collective term for abdominal symptoms such as abdominal pain and indigestion that occur after surgery in patients with a history of cholecystectomy. Abdominal pain or “dyspepsia” (a feeling of fullness in the upper abdomen or right upper abdomen, abdominal rumbling, nausea, vomiting, constipation, fat intolerance, or diarrhea) occurs within a few weeks after surgery in half of PCS patients, and within months or years after surgery in the other half. These symptoms are nonspecific and vary depending on the underlying etiology, but often include pain in the right upper abdomen or epigastrium, most often after meals, which is sharp. Other symptoms may include heartburn, belching, vomiting, and intolerance to a fatty diet. So, what are the differential diagnoses for patients who are intolerant to a fatty diet? The following is a brief description: 1, endogenous depression: including monophasic depression, bipolar disorder (both depressive and manic episodes), and depression related to schizophrenia. 2. Somatic depression: caused by various physical and neurological diseases, also including those caused by drugs and various harmful substances. 3. Psychogenic and reactive depression: Psychogenic depression, as a rule, only occurs once in a lifetime. If there are two episodes, it should be regarded as a reaction to deviation from the normal personality or simply endogenous depression. From the previous description, it is clear that the prevention and reduction of PCS lies first of all in the establishment of a complete and correct diagnosis before surgery, with attention to the exclusion of tumors and lesions of the organs adjacent to the gallbladder, and a correct estimation of the causes of the patient’s symptoms in order to reduce or eliminate unnecessary surgery. Patients should be told what symptoms may occur after surgery, which ones can be relieved, which ones are not affected by surgery, and which ones still need further treatment, and they should be informed of the process of postoperative diet and other aspects that still require gradual adaptation. Relevant knowledge, skills and experience are required for the surgical operation, and pathological examination or intraoperative cholangiography is performed if necessary for potentially malignant lesions. Furthermore, the drainage tube should not be left in place for too long after surgery, and it is advisable to perform a T-tube imaging before extraction.
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