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Postcholecystectomy syndrome (PCS) describes the presence of abdominal symptoms after a cholecystectomy (gallbladder removal). Symptoms occur in about 5 to 40 percent of patients who undergo cholecystectomy, [1] and can be transient, persistent or lifelong. [2] [3] The chronic condition is diagnosed in approximately 10% of postcholecystectomy ...
Biliary sludge has been associated with pregnancy, rapid weight loss, total parenteral nutrition, drugs such as ceftriaxone and octreotide, solid organ transplantation, and gastric surgery. [1] [2] In many of these conditions, it is thought that the impairment in the contractility of the gallbladder leads to the formation of the sludge. [2]
Biliary microlithiasis refers to the creation of small gallstones less than 3 mm in diameter in the biliary duct or gallbladder. It has been suggested [1] as a cause of postcholecystectomy syndrome, or PCS, the symptoms of which include: Upset stomach, nausea, and vomiting. Gas, bloating, and diarrhea. Persistent pain in the upper right abdomen ...
It shows a gallbladder wall that is almost pathologically thickened, at 3 mm. However, there is no apparent edema in the pericholecystic fat. The gallbladder contains biliary sludge, as well as gallstones, which create acoustic shadowing. There is thus gallstones without current cholecystitis.
The first is how often and how well the gallbladder contracts; incomplete and infrequent emptying of the gallbladder may cause the bile to become overconcentrated and contribute to gallstone formation. This can be caused by high resistance to the flow of bile out of the gallbladder due to the complicated internal geometry of the cystic duct. [36]
Patients with cholelithiasis typically present with pain in the right-upper quadrant of the abdomen with the associated symptoms of nausea and vomiting, especially after a fatty meal. The physician can confirm the diagnosis of cholelithiasis with an abdominal ultrasound that shows the ultrasonic shadows of the stones in the gallbladder.
Gallstones and biliary sludge, but the gallbladder wall is not clearly thickened, with no edema in the pericholecystic fat, thus not cholecystitis. Acute cholecystitis as seen on ultrasound. The closed arrow points to gallbladder wall thickening.
The presence of gallstones, usually visualized by ultrasound, generally necessitates a surgical treatment (removal of the gall bladder, typically via laparoscopy). [ 27 ] Removal of the gallbladder with surgery, known as a cholecystectomy , is the definitive surgical treatment for biliary colic.