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Clinical patterns of postcholecystectomy syndrome
Ann Hepatobiliary Pancreat Surg 2018 Feb;22(1):52-7
Published online February 28, 2018
Copyright © 2018 Ann Hepatobiliary Pancreat Surg.

Bader Hamza Shirah1, Hamza Asaad Shirah2, Syed Husham Zafar3, and Khalid B Albeladi4

1King Abdullah International Medical Research Center/King Saud bin Abdulaziz University for Health Sciences, Jeddah, Departments of 2General Surgery and 3Medicine, Al Ansar General Hospital, Medina, 4King Abdulaziz Medical City/King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
Received August 7, 2017; Revised August 31, 2017; Accepted September 17, 2017.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Backgrounds/Aims: Postcholecystectomy syndrome represents a heterogeneous group of symptoms and findings in patients who have previously undergone cholecystectomy. It is rare and under-reported in Saudi Arabia. It can be attributed to many complications such as bile duct injury, biliary leak, retained common bile duct stones, recurrent bile duct stones, and bile duct strictures. In this study, we aimed to analyze the causes and evaluate the approach to postcholecystectomy syndrome in our local Saudi Arabian community because of the vast number of cases encountered in our hospital for gallbladder clinical conditions and its related complications. Methods: A prospective cohort database analysis of 272 patients who were diagnosed and treated for postcholecystectomy syndrome between January 2000 and December 2013 were reviewed. Results: The incidence rate of postcholecystectomy syndrome was 19.8%. The male to female ratio was 1:1.45. The mean age was 37.41±7.12 years. The most common causes were as follows: No obvious cause in 50 (18.4%) patients, Helicobacter pylori infection in 43 (15.8%), pancreatitis in 42 (15.4%), peptic ulcer disease in 41 (15.1%), recurrent common bile duct (CBD) stone in 26 (9.6%), retained CBD stone in 22 (8.1%), bile leakage in 19 (7%), stenosis of the sphincter of Oddi in 12 (4.4%), cystic duct stump syndrome in 11 (4%), and CBD Stricture in 5 (1.8%). The mortality rate was 0%. Conclusions: Any clinical presentation of postcholecystectomy should not be underestimated and be thoroughly investigated. Multidisciplinary collaboration is crucial for the best outcome and a safe approach for all the patients. (Ann Hepatobiliary Pancreat Surg 2018;22:52-57)
Keywords : Postcholecystectomy syndrome; Laparoscopic cholecystectomy; Gallstones; Bile duct injury; Biliary leak; Jaundice


February 2018, 22 (1)