Post cholecystectomy syndrome

  Cholecystectomy for gallbladder stones and cholecystitis has become a common operation in China, and most patients recover well after surgery, with a significantly better diet and no abdominal pain. However, some patients still have epigastric pain after surgery, which is aggravated after eating and recurrent, and even jaundice, which some people call “post-cholecystectomy syndrome”, the main reason of which is the residual gallbladder duct is too long or the gallbladder is not completely removed during surgery, also called “residual gallbladder” after cholecystectomy. This is also called “residual gallbladder” or “small gallbladder” after cholecystectomy, which usually occurs 1 year after surgery, and in severe cases, stones may recur and require reoperation.  Anatomically, the gallbladder is connected to the common bile duct, and over time, the residual overgrown duct will gradually become a blind end, or even a “small gallbladder”, or because of adhesions, the surgeon is afraid of damage and only performs the majority of gallbladder removal. Therefore, the symptoms of cholecystitis may reappear. In the past 2 years, our department has admitted 5 patients with recurrent abdominal pain after cholecystectomy in hospitals. The root cause of this is that intraoperative infection of the gallbladder is severe and the duct is densely adherent to the common bile duct. In addition, there are also small stones left in the gallbladder, which later develop into common bile duct stones causing cholangitis and jaundice, or biliary pancreatitis caused by benign incomplete stenosis at the end of the common bile duct.