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Postcholecystectomy Syndrome.

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My husband had a Lap Chole about 3 weeks ago. He is still having nausea, RUQ pain that radiates around to his back, frequent diarrhea episodes daily, pain that is getting worse but is tolerable. He has lost about 8-10lbs in the last 3 weeks. Tries to keep hydrated with water and gatorade everyday. His appetite has been normal for him, until this week when began having the increased diarrhea. He thinks he has pancreatic cancer because of the symptoms he is having. He is 5ft 11in and weighs 205lbs. Had some lab work done the other day that showed a fasting BG of 107. Amylase and Liver enzymes were WNL. Does this information I have given you make you think "Pancreatic Cancer," or even that it is a possibility? What else do you think it might be? other possibilities?


Category: Internal Medicine Specialist

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Category: Sexually Transmitted Diseases(STD)Specialist
Dr. Deepu Sebin Sebastian is online now

Expert:  Dr. Deepu Sebin Sebastian replied 4 Days.

Hello and thankyou for approaching DoctorSpring with your query.
I have gone through your husbands case and understand your concern.
From what you have described the symptoms seem to be related to his surgery and is probably something known as postcholecystectomy syndrome (PCS)
It occurs in some individuals after Laparoscopic Cholecystectomy. In some it occurs soon in the postoperative period while in some can occur decades later.

PCS is caused by alterations in bile flow due to loss of the reservoir function of the gall bladder. In some the bile flows in the upper part of the gastrointestinal tract resulting in symptoms related to the stomach and oesophagus while in others the it affects the lower gastrointestinal tract where patient experiences diarrhea and colicky abdominal pain.

Your husband is not likely to have pancreatic cancer. An ultrasound would have been done prior to surgery, and if there was any abnormality in the pancreas, it would have shown then. It would not have developed so soon.

However you will have to go and get him evaluated to see what the underlying cause of PCS is, like retained stone, bile duct leak, stricture or could be other gastrointestinal causes.
You will require to get an ultrasound or CT done. Depending on which you may have to get a magnetic resonance cholangiopancreatography (MRCP) done.

I hope this has helped. Please feel free to follow up.
Thankyou




Dr. Deepu Sebin Sebastian
Category: Sexually Transmitted Diseases(STD)Specialist
Experience: 
MD, Internal Medicine - Stanley Medical School
Medical School - MBBS - Govt. Medical College, Kottyaam

Diagnostic Prediction - Stanford School of Medicine
Received Specialty training in Critical Care, Cardiology, Neurology, Gastroenterology, Nephrology from Stanley Medical College and in Endocrinology, Rheumatology.

Hematology and Geriatrics from Madras Medical College.
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