Postcholecystectomy Syndrome Clinical Presentation

Updated: Dec 27, 2016
  • Author: Steen W Jensen, MD; Chief Editor: John Geibel, MD, DSc, MSc, AGAF  more...
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Presentation

History

A wide range of symptoms may be noted in patients with postcholecystectomy syndrome (PCS). Symptoms are sometimes considered to be associated with the gallbladder. Freud found colic in 93% of patients, pain in 76%, jaundice in 24%, and fever in 38%. [11] In the author’s patient population, the incidence of PCS is 14%. Pain is found in 71% of patients, diarrhea or nausea in 36%, and bloating or gas in 14%. The cause of PCS is identifiable in 95% of patients.

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Physical Examination

The workup for PCS varies. An extensive study of the patient should be performed in an attempt to identify a specific cause for the symptoms and to exclude serious postcholecystectomy complications. Surgical reexploration should be considered a last resort.

Patient examination starts with a thorough history and a careful physical examination, with close scrutiny of the old record. Particular attention should be paid to the preoperative workup and diagnosis, the surgical findings and pathologic examination, and any postoperative problems. Discrepancies may lead to the diagnosis. Additional workup is directed at the most likely diagnosis while excluding other possible causes.

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