What is postcholecystectomy syndrome (PCS)?

Updated: Nov 28, 2018
  • Author: Steen W Jensen, MD; Chief Editor: John Geibel, MD, MSc, DSc, AGAF  more...
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The term postcholecystectomy syndrome (PCS) describes the presence of symptoms after cholecystectomy. [1, 2] These symptoms can represent either the continuation of symptoms thought to be caused by gallbladder pathology or the development of new symptoms normally attributed to the gallbladder. PCS also includes the development of symptoms caused by removal of the gallbladder (eg, gastritis and diarrhea).

In general, PCS is a preliminary diagnosis and should be renamed with respect to the disease identified by an adequate workup. It arises from alterations in bile flow due to loss of the reservoir function of the gallbladder. Two types of problems may arise. The first is continuously increased bile flow into the upper gastrointestinal (GI) tract, which may contribute to esophagitis and gastritis. The second is related to the lower GI tract, where diarrhea and colicky lower abdominal pain may result. [3] This article mainly addresses the general issues of PCS.

PCS reportedly affects about 10-15% of patients. In the author’s experience, PCS has occurred in 14% of patients. Effective communication between patients and their physicians, with specific inquiry directed at eliciting frequently anticipated postoperative problems, may be necessary to reveal the somewhat subtle symptoms of PCS.

Treatment should be governed by the specific diagnosis made and may include pharmacologic or surgical approaches.

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