From the Guidelines
Yes, it is possible to experience biliary colic-like symptoms after cholecystectomy, which can be caused by complications such as bile duct injury or stricture, as reported in a 2021 study 1. These symptoms can occur in patients who have undergone gallbladder removal, and the pain may be similar to the original biliary colic, manifesting as upper right abdominal discomfort that may radiate to the back or shoulder. The management of these symptoms depends on the underlying cause, and treatment options may include pain medications, antispasmodics, or endoscopic procedures to remove stones or relax the sphincter, as well as dietary modifications to reduce symptoms. Some possible causes of these symptoms include:
- Retained or newly formed gallstones in the bile ducts
- Bile duct injury, which can lead to complications such as post-cholecystectomy biliary strictures, recurrent cholangitis, and secondary biliary cirrhosis, as noted in the 2021 study 1
- Sphincter of Oddi dysfunction, where the muscle controlling bile flow spasms
- Biliary dyskinesia, or abnormal bile flow. It is essential to consult a doctor for proper diagnosis and treatment if you experience persistent pain after gallbladder surgery, as these symptoms can sometimes indicate complications requiring specific interventions, such as surgical intervention, naso-biliary drainage, or endoscopic sphincterotomy with biliary stenting, which have been shown to have satisfactory long-term outcomes in the treatment of bile duct injuries 1.
From the Research
Biliary Colic after Cholecystectomy
- Biliary colic can occur after cholecystectomy, as some individuals may still experience symptoms of the biliary system thereafter 2.
- Postcholecystectomy syndrome (PCS) is a condition where patients experience persistent biliary symptoms after gallbladder removal, and it can occur in up to 10% of individuals after cholecystectomy 2, 3.
- The causes of PCS are varied and can include extra-biliary conditions that may have existed before the operation, as well as biliary causes such as choledocholithiasis, bile duct injury, and sphincter of Oddi dysfunction 2, 4.
- Biliary colic can be a symptom of PCS, and it is essential to differentiate biliary from non-biliary causes of the patient's symptoms to determine the most appropriate treatment and disposition of the patient 4.
- Studies have shown that urgent laparoscopic cholecystectomy may be the best management for biliary colic, as it can reduce the probability of recurrent emergency admission and decrease the risk of complications 5.
Management of Postcholecystectomy Complications
- The management of postcholecystectomy complications, including biliary colic, requires a multidisciplinary approach and can involve various therapeutic options, including endoscopy and surgical intervention 3, 6.
- It is crucial to obtain a critical view of safety and follow the tenets of the Safe Cholecystectomy Task Force to aid in the prevention of bile duct injury and other morbidity associated with cholecystectomy 6.