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Gallstone Pancreatitis Post Laparoscopic Cholecystectomy: A Case Report
Jonathon H Hines1, Sujesh Pillai2
1College of Osteopathic Medicine, Sam Houston State University, Conroe, USA.
Cureus
|July 3, 2023
Summary
Gallstone pancreatitis is rare after gallbladder removal surgery. This case highlights the importance of considering this diagnosis in patients with post-cholecystectomy abdominal pain, even with negative initial imaging.
Area of Science:
- Gastroenterology
- Surgical Outcomes
Background:
- Laparoscopic cholecystectomy is a common procedure for gallstone disease.
- Gallstone pancreatitis post-cholecystectomy is an uncommon complication.
Observation:
- A 38-year-old female presented with severe epigastric pain radiating to the back, nausea, and vomiting three weeks after laparoscopic cholecystectomy.
- Initial laboratory results showed elevated liver enzymes and lipase.
- Preoperative magnetic resonance imaging (MRI) and magnetic resonance cholangiopancreatography (MRCP) did not reveal common bile duct stones.
Findings:
- Endoscopic retrograde cholangiopancreatography (ERCP) identified distal common bile duct stones.
- Gallstones were successfully removed via ERCP with biliary sphincterotomy.
- The patient experienced an uneventful postoperative recovery.
Implications:
- Physicians should maintain a high index of suspicion for gallstone pancreatitis in patients with recent cholecystectomy presenting with characteristic symptoms.
- Delayed diagnosis of gallstone pancreatitis can occur due to its infrequent occurrence and potential for negative initial imaging.
- ERCP remains a crucial diagnostic and therapeutic tool for managing retained common bile duct stones.
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