Summary
One hundred and twenty two patients with postcholecystectomy symdrome were studied by endoscopic retrograde cholangiopancreatography (ERCP). The procedure was succesful in 105 patients (85.3%) and it accurately detected abnormality of the pancreatico-biliary system in 71 patients (67.6%). ERCP results were abnormal in 82.6% of patients with biliary symptoms, with or without jaundice, compared with 34.7% of patients with non-biliary symptoms (P<0.001). Though ERCP showed abnormality in all patients with biliary symptoms and jaundice, as many as 70.4% of patients without jaundice had abnormal ERCP. The commonest abnormality was retained/recurrent stones (37/105 patients). Patients with biliary strictures presented significantly more often with jaundice compared with patients with biliary stones (74.3% vs 22.3%). In 19 of the 37 patients with retained biliary stones endoscopic sphincterotomy was performed and it was successful in 16 patients (84.2%). Our data indicates that ERCP detects the anatomical level as well as the nature of lesion accurately, and is essential and safe in the diagnosis and management of patients with postcholecystectomy syndrome.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Bodvall B: The postcholccystcctomy syndromes. Clin Gastroenterol 1973;1:103–126
Christiansen J, Schmidt A: The postcholecystectomy syndrome. Acta Chir Scand 1971;137:789
Domellof L, Schersten J: Prognosis of early postcholecystectomy distress. Analysis of 593 patients cholecystectomised for gall stone disease. Acta Chir Scand 1968;134:291
Schofield GE, Macleod RG: Sequelae of cholecystectomy. Br J Surg 1966;53:1042
Axon ATR, Classen M, Cotton PB, et al: Pancreatography in chronic pancrcatitis International definitions. Gut 1984;25: 1107–1112
Blumgart LH, Carachi R, Imrie CW, et al: Diagnosis and management of postcholecystectomy symptoms. The place of endoscopy and retrograde cholangiopancreatography. Br J Surg 1977;64:809–816
Shapiro HA: Endoscopic diagnosis and treatment of biliary tract disease. Surg Clin North Am 1981 ;61:843–864
Ruddell WSJ, Ashton MG, Lincott DJ, et al: Endoscopie retrograde cholangiography and pancreatography in investigation of post-cholecystectomy patients. Lancet 1980;1:444–446
Tondclli P, Gyr K: Biliary tract disorders postsurgical syndromes. Clin Gastroenterol 1980;12:444
Makwane UK, Kumar N, Nanda R, et al: Role of endoscopie retrograde cholangiopancreatography (ERCP) in patients with postcholecystectomy problems. Indian J Gastroenterol 1987;6: 11–13
Ashton MG, Axon ATR, Lintcott DJ: Lundh test and ERCP in pancreatic disease. Gut 1978;19:910–915
Sugawa C, Clift D, Walt AJ: Endoscopie retrograde cholangiopancreatography after cholecystectomy. Surg Gyn Obst 1983;57:247–251
Coopedrman M, Ferrara JJ, Carey LC, et al: Endoscopie retrograde cholangiopancreatography. Its use in the valuation of non jaundice patients with post cholecystectomy syndrome. Arch Surg 1981;116:606–609
Bar-Meir S, Halpern Z: The significance of the diameter of the common bile duct in cholecystectomised patients. Am J Gastroenterol 1984;79:59–60
Bar-Meir S, Geenan JR, Hogan WJ, et al: Biliary and pancreatic duct pressures. Measured by ERCP manometry in patients with suspected papillary stenosis. Dig Dis Sci 1979;24:209–213
Geenen JE. Vennes JA, Silvis SE: Resume of a seminar on endoscopie retrograde sphincterotomy (ERS). Gastrointest Endosc 1981;27:31–38
Mathur SK, Naik SR: Diagnostic evaluation of postcholecystectomy symptoms. Indian J Gastroenterol 1987;6:5–6
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Dilawari, J.B., Chawla, Y.K., Singhal, A.K. et al. Postcholecystectomy syndrome in Northern India — study on the diagnostic and therapeutic role of ERCP. Gastroenterol Jpn 25, 394–399 (1990). https://doi.org/10.1007/BF02779457
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02779457