Postcholecystectomy Syndrome

Postcholecystectomy Syndrome: Causes, Symptoms, and Treatment

Postcholecystectomy is medical condition after cholecystectomy. Cholecystectomy is a surgical procedure for gallbladder removing. The occurrence of abdominal symptoms after gallbladder surgery is Postcholecystectomy. Approximately 5% to 40% of people develop the Postcholecystectomy syndrome after gallbladder surgery. Some patients need to admit in the hospital when symptoms occur. But, a large number of people do not have any signs. Affected people can confirm the symptoms after a year.

Causes of Postcholecystectomy

Some people develop health problems after gallbladder surgery. The severe complication occurs which caused by conditions such as

Bile Leakage

During surgery, a small hole or injury causes the bile leakage. The gallbladder is a small organ looks like a sac. The human body has it under the liver on the right side of the abdomen. The gallbladder contains bile which is a greenish-brown fluid to help digestion. The bile helps to break down the fat to get absorbed. The bile leak in the abdomen area will cause Postcholecystectomy.

Incorrect Diagnosis Of Preoperative

In most cases, symptoms show the false preoperative diagnosis. The patient may get the same symptoms after surgery. It shows that the patient is suffering from a disease different from the gallbladder. In such conditions, it is impossible to stop gallbladder surgery. So, it is necessary to tell your doctor about a previous health problem. Earlier disease history can help to recognize the symptoms. There may be other condition, which gets affected by gallbladder surgery. This condition will cause Postcholecystectomy.

Pancreatic Disease

Gallbladder surgery impacts the pancreas. Patient without gallbladder may feel pressure on the pancreas. The possible problems may occur such as

  • Premature activation of digestive enzyme
  • Pancreatic damage
  • Pancreas inflammation

Thus, the affected pancreases cause Postcholecystectomy.

Hepatic Disease Causes Postcholecystectomy

Removing gallbladder also affect on the liver. It is also one of the causes of Postcholecystectomy. The liver cannot store the bile between meals. The gallbladder work is to squeeze the bile in the intestine for food and fat digestion. When there is no gallbladder, the bile flows in a limited way. Other causes such as

  • Frequent bile secretion affect food metabolism
  • Digestive and diarrhea problem
  • Bile secretion reduces liver congestion
  • The liver may become weak

Why You Need Gallbladder Surgery (Cholecystectomy)?

A lifestyle, genes, weight and diet impact on gallbladder and bile system. It causes gallstone. Cholesterol and pigment cause to form stones. Sometimes stone occurs due to a problem with the gallbladder itself. This stone creates infection in the gallbladder. It is a common disorder of a digestive system. Sometimes the stone grows hard and needs surgery to remove it. This surgery is called a cholecystectomy. In some condition, there is a need to remove the gallbladder. You can survive without a gallbladder. But, you need to maintain a diet.

Other Conditions For Gallbladder Surgery

Gallbladder Cancer

gallbladder cancer

Gallbladder cancer is a significant cause for operation. Removing the gallbladder helps to decrease the pain. It also stops cancer from spreading to other organs. If cancer grows out of the gallbladder, you may need other surgeries also.

A chemical compound in bile form gallstones. Mild gallstones can dissolve but sever gallstones need removal surgery.

Gallbladder Inflammation

The inflammation of the gallbladder also recognized as cholecystitis. The infection occurs when a gallstone blocks gallbladder. This condition leads to pain and fever. Increased inflammation of cholecystitis causes a hole in the gallbladder. This condition required emergency gallbladder removal surgery.

Bile Duct Gallstones

Gallstone in bile duct blocks the bile flow from liver or gallbladder. The bile blockage leads to infection and pain. If the infection persists, your skin will turn yellow. It named as choledocholithiasis in medical terms. It needs quick medical attention.

Pancreas Inflammation

Pancreatitis

When a gallstone block the pancreatic duct, can lead to pancreas inflammation. It causes severe abdominal pain and requires surgery.

Symptoms of Postcholecystectomy

The people with postcholecystectomy will get similar symptoms of the gallbladder problem.

Abdominal Pain

You may develop abdominal pain after gallbladder surgery. The chronic pain reoccurs on the right side of the abdomen. Patient with Cholecystectomy may get the earlier pain.

Another cause of abdominal pain is a problem in bile ducts. The gallbladder is a part of the bile duct system. It helps to drain the liver. Stones can reoccur in other bile ducts like a sphincter. The sphincter controls the bile flow in the intestine tract. The other diseases which occur after cholecystectomy such as

  • Peptic ulcer
  • Rib of chest inflammation
  • Irritable bowel syndrome

Vomiting and Nausea

vimiting

There is no gallbladder after surgery controls the bile flow. The bile flow can work, but limited to the small intestine. Temporarily, it leads to nausea and vomiting. It may not need treatment. You may need doctor help if nausea occurs frequently.

In some cases, gallstone remains in the bile duct after surgery. It also leads to vomiting and nausea in Postcholecystectomy.

Jaundice

Postcholecystectomy Syndrome3

Jaundice is a common symptom of gallbladder surgery. You can notice the symptoms such as yellow skin and yellow eyes. The doctor may diagnose this condition as a problem with bile or liver. The occurrence of jaundice shows that still, a stone has blocked the bile duct. The stone blocks bile flow in the intestine, which results in bile storage. The Jaundice is a severe health condition which needs medical help.

Fever

Fever is a symptom of septic or wound after surgery. The abdominal part wounds can be a symptom of getting the fever. Also, there are chances of fluid build-up in the liver. You need to inform your surgeon. You can have an ultrasound and blood test to confirm the infection. Another cause of fever is the reaction of damaged tissues.

However, fever after Postcholecystectomy show the signs such as

  • Infection
  • Bleeding
  • Pneumonia
  • Blood clotting
  • Heart disease
  • Pus drainage in surgery
  • Prolonged abdominal surgery

Diagnosis of Postcholecystectomy

The Postcholecystectomy patient needs biliary disease examination. You may get the pain such as alkaline phosphatase, biliary colic, amylase, and lipase. The rise of biochemical parameters shows a dysfunction of the sphincter of Oddi. The growth of lipase and amylase shows a problem with the pancreatic sphincter. In a lipase test, the doctor will examine the protein level and fats.

Another dysfunction is biliary manometry. It helps to diagnosis the raised pressure in the biliary tract. It is the cause of pain and develops the risk of pancreatitis. The reduced passage from the liver to the duodenum shows in the scan report. It tells about sphincter Oddi dysfunction.

The doctor can stop the pain of Oddi sphincter dysfunction by endoscopic sphincterotomy. Mainly it helps papillary stenosis. But, it can be a problem for Postcholecystectomy patients without physical disease.

Important things to remember

  • Consult a Herpetologist
  • Have Gallbladder test
  • Have a biliary tract and gallbladder ultrasound test
  • Have a diagnosis of gallbladder area and liver

What happens in Postcholecystectomy?

  • Before transfer to room or home, you need to have a check-up in the recovery section
  • Your doctor will give you pain relieve antibiotics.
  • A tube may need to insert to remove the swallowed air until bowl movement work again.
  • You may be able to have food after a few hours.
  • You will get a follow-up appointment with the doctor.

Remember to keep your surgery area clean. Avoid difficult work and keep someone to help you. Follow your doctor’s advice for better recovery. Call your doctor immediately if you have the following symptoms.

  • Unusual body temperature
  • Swollen incision
  • If your incision has discharge or foul smell
  • Continues pain incision area
  • Continues abdominal pain and cramps
  • Irregular bowel movement
  • Pain around breastbones

Postcholecystectomy Treatments

Medical treatment is often successful for the postcholecystectomy syndrome. Finding a proper cause of pain can help to decide the suitable treatment. The specific postcholecystectomy reason can help with the surgery.

For a patient with failed medical treatment requires reverse treatment such as

  • Endoscopic retrograde cholangiopancreatography
  • Interventional procedure

Almost 33% of all patients get persistent pain after cholecystectomy. The doctor will determine, whether the small gallstone is the cause of pain or not. The doctor will check whether the gallstones will get dissolve by ursodeoxycholic acid therapy or not.

Here Are The Following Treatments For Postcholecystectomy

Surgical intervention: Sphincteroplasy is the removal of a sphincter by surgery. The sphincter is the leading cause of bile leakage. It needs to correct with surgery.

  • Sedative: It helps patient for relaxing
  • Antispasmodics: This medicine also helps with muscle relaxation. It is only for sphincter and unresponsive to other treatments.
  • Nitrates & Calcium channel blockers: It helps to treat irritable sphincter.
  • Antidiarrheal: The cholestyramine can help to relieve diarrhea.
  • Antacids: It helps to reduce the abdominal discomfort.

Diet for Postcholecystectomy

jiuce

Follow the diet plan if you just had a gallbladder removal surgery. After surgery, you need to maintain a liquid diet. It can help to reduce the body discomfort. The surgical intervention trauma can treat with a liquid diet for the initial weeks. During recovery time you need to eat food slowly. It helps put less pressure on the digestive system.

Maintain a soft diet after recovery. This diet should be nutritious and well-balanced.

You need to limit the fat. The digestive system finds it hard to digest fat after gallbladder surgery. Still, you need to eat fat. You should not take more than 30% calories of your daily intake. If you have 1,800 calories every day, limit the fat no more than 60 gm. Your pancreas is still working for pumping digestive enzymes. It helps to break the fat. Therefore, make a wise choice for good fats such as

  • Coconut oil
  • Avocados
  • Olives
  • Almond and walnuts
  • Seeds like Flaxseed, psyllium, chia seeds
  • chia seeds, flaxseed, and psyllium

Eat fruits and vegetables. It will provide natural benefits to infection resistance. The specific vegetables and fruits for recovery after gallbladder surgery such as

  • Cabbage
  • Broccoli
  • Kale
  • Green bell pepper
  • Mustard greens
  • Collard greens
  • Carrot
  • Onion
  • Lentils
  • Apple
  • Banana
  • Grapefruit
  • Orange
  • Pears

Eat plenty of protein for fast recovery. The foods high in protein will get digested easily. Avoid beef which looks like a marble. Instead, try eating

  • The lean piece of beef meat
  • White chicken meat
  • Fish – Flounder, Halibut, and Cod

Avoid high-fat foods that create discomfort

Eating a high-fat diet can cause you diarrhea, pain, and bloat. To avoid gastrointestinal problem skip the following foods

Meal Intake Routine

During Postcholecystectomy, you may need to change your eating routine. There is no gallbladder to help digestion. Your body may find easy to digest if you have a frequent small meal. If you are eating three times, make it four times in a whole day.

Complication

You may get the following complications after cholecystectomy.

Pancreatitis

It is an uncommon complication which occurs after cholecystectomy. If the gallstone block pancreas duct, it may cause inflammation. Generally, the pain goes away after weeks of gallstone surgery. But, the proper diagnosis is essential for better treatment. In some cases inflamed pancreas unable to produce insulin. It may develop chances of diabetes.

Hyperamylasemia

It is a condition of the excessive pancreatic enzyme. The gallbladder infection, gallstone cause to increase pancreatic enzyme. It will cause you nausea.

According to the research laparoscopic gallbladder surgery has transformed the gallstone treatment. It has changed with open cholecystectomy as a standard method. In spite of its many benefits this surgery risk with bile duct injuries. It has elicited a revived interest in the problem of bile duct strictures.

Biliary injuries nursed during laparoscopic cholecystectomy. It varies from patients linked with open cholecystectomy. The mechanism of injury was different for every patient. During laparoscopic cholecystectomy, a bile duct is misunderstood to be the cystic duct. It divided and clipped. The hepatic duct also split for removing the gallbladder. It was assumed to be an accessory duct. Finally, it caused the loss of bile duct segment. Additionally, the right hepatic artery got injured. Hence, the post laparoscopic cholecystectomy associated with a high risk of injury.

Maintain a healthy diet to keep your gallbladder free from getting gallstone. If you get symptoms, consult a doctor. Always take your doctor advice before taking any supplement or food to avoid further health problems.

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