Pain Years After Gallbladder Removal

After removing the gallbladder, certain abdominal pains may appear years later. We will tell you about the connection of this pain with the absence of a gallbladder in a person in this article.

What Is Pain Years After Gallbladder Removal Mean?

Postcholecystectomy syndrome (PCS) explains the presence of abdominal symptoms two ormore years after a cholecystectomy (gall bladder removal).

Symptoms occur in about 5 to 40 percent of patients who go through cholecystectomy, and can be transient, consistent or lifelong. The chronic condition is diagnosed in roughly 10% of postcholecystectomy cases.

The pain connected with postcholecystectomy syndrome is normally ascribed to either sphincter of Oddi dysfunction or to post-surgical adhesions. A current 2008 research study reveals 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 staying 50% are due to non-biliary causes. This is since upper abdominal pain and gallstones are both typical but are not constantly associated.

How to Recognize the Pain Years After Gallbladder Removal

Patients with pain years after gallbladder removal should be assessed as shown for extrabiliary as well as biliary causes. If the pain recommends biliary colic, alkaline phosphatase, bilirubin, ALT, amylase, and lipase ought to be determined, and ERCP with biliary manometry or biliary nuclear scanning should be done (see Laboratory Tests of the Liver and Gallbladder and Imaging Tests of the Liver and Gallbladder). Raised liver tests recommend sphincter of Oddi dysfunction; elevated amylase and lipase suggest dysfunction of the sphincter’s pancreatic portion.

Dysfunction is best found by biliary manometry done throughout ERCP, although ERCP has a 15 to 30% danger of inducing pancreatitis. Manometry shows increased pressure in the biliary tract when pain is reproduced. A slowed hepatic hilum-duodenal transit time on a scan also recommends sphincter of Oddi dysfunction. Diagnosis of papillary stenosis is based upon a specific history of frequent episodes of biliary pain and unusual liver (or pancreatic) enzyme tests.


Endoscopic sphincterotomy can alleviate reoccurring pain due to sphincter of Oddi dysfunction, especially if due to papillary stenosis. Endoscopic retrograde cholangiopancreatography (ERCP) and manometry have been used to deal with postcholecystectomy pain; nevertheless, no existing proof indicates that this treatment is efficacious if patients have no objective abnormalities. These patients must be dealt with symptomatically.

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