Enriched view of postcholecystectomy syndrome: Nowadays and in former times

Abstract

Aim-Background:The aim of the present review is to evidence the differences in the nature of PCS between open and laparoscopic cholecystectomy and also to examine how this condition has evolved over the years. In 5 to 40% of patients with cholelithiasis, regardless of the type of surgery, the symptoms persist postoperatively, leading to the development of the so-called postcholecystectomy syndrome (PCS). The time of the onset of symptoms ranges from 2 days to 25 years after cholecystectomy.Methods: A total number of 926 articles were found as a literature reference pool. We searched English language articles published in Medline, Scopus and google scholar. Only review articles were retrieved because no comparative studies or prospective clinical trials were found to provide statistically significant conclusions. The final group of articles was reviewed, and a total of 57 papers were used for the present review. Results:The literature is conflicting as concerns the pathophysiology and the aetiology of PCS. Regardless of the type of surgery, it seems that PCS is correlated to age and sex. The prevailing view is that retained or recurrent gallstones, gallbladder remnants and Sphincter of Oddi dysfunction are the primary causes. Moreover, systemic diseases of the gastrointestinal (GI) tract, cardiac disorders, autoimmune diseases, nervous system and psychological distress can mimic PCS symptoms. Nonetheless, there are many available techniques regarding diagnosis and treatment. Nowadays, the majority of researchers endorse ERCP as the gold standard for diagnosis and treatment. Conclusion:The preoperative meticulous investigation of patients with cholelithiasis is mandatory in order to identify coexisting disorders related to PCS, achieve a better therapeutic approach, and principally reduce PCS incidence.

Cholelithiasis and chronic cholecystitis in a ten-year-old-boy: a case report

“…PCS also includes developing symptoms caused by removing the gallbladder (e.g., gastritis and diarrhea). 21 In this case, the patient had no sign of infection after the surgery and did not complain of any sign of nausea and emesis.…”

“…Complications associated with cholecystectomy were also explained in the previous study. 21 This journal concluded that complications include hemorrhage, infection, bile duct injury, ileus, pancreatitis, and post-cholecystectomy syndrome. 21 The term post-cholecystectomy syndrome (PCS) describes the presence of symptoms after cholecystectomy.…”

“…21 This journal concluded that complications include hemorrhage, infection, bile duct injury, ileus, pancreatitis, and post-cholecystectomy syndrome. 21 The term post-cholecystectomy syndrome (PCS) describes the presence of symptoms after cholecystectomy. 21 These symptoms can represent either the continuation of symptoms thought to be caused by gallbladder pathology or the development of new symptoms generally attributed to the gallbladder.…”

“…21 The term post-cholecystectomy syndrome (PCS) describes the presence of symptoms after cholecystectomy. 21 These symptoms can represent either the continuation of symptoms thought to be caused by gallbladder pathology or the development of new symptoms generally attributed to the gallbladder. PCS also includes developing symptoms caused by removing the gallbladder (e.g., gastritis and diarrhea).…”

Acupuncture for the postcholecystectomy syndrome

“…[4] In 5% to 40% of patients with cholelithiasis, regardless of the type of surgery, the symptoms persist postoperatively. [5,6] And the incidence rate of the PCS in this study's population was 19.8%. [7] Approximately 5% to 40% of patients who have undergone cholecystectomy continue to have symptoms of abdominal pain, vomiting, gastrointestinal symptoms (dyspepsia, loose stool, and the like) and are thought to suffer from PCS.…”