Evaluation of Post-cholecystectomy Syndrome in Patients With Gallstone Disease: A Critical Appraisal

Laparoscopic cholecystectomy is the gold standard treatment for gallstones, offering a minimally invasive approach with quicker recovery times. Despite its effectiveness, a significant proportion of patients experience persistent symptoms post-surgery, collectively referred to as post-cholecystectomy syndrome (PCS). The incidence, causes, and management of PCS remain underexplored. This study aimed to evaluate the incidence of PCS among adult patients undergoing elective laparoscopic cholecystectomy for benign gallstone disease at Pilgrim Hospital, Boston, UK, and to identify potential contributing factors.

We conducted a retrospective study, reviewing data from patients who underwent elective laparoscopic cholecystectomy between January 1, 2024, and July 31, 2024. Data were collected through electronic records and patient questionnaires completed over the phone. The study analyzed patient demographics, symptoms post-surgery, and subsequent investigations and treatments.

Out of 50 patients included in the study, 17 (34%) reported ongoing symptoms consistent with PCS. The most common symptoms were right upper quadrant (RUQ) pain (48%) and diarrhea (33%). Further investigations, including magnetic resonance cholangiopancreatography (MRCP) and esophagogastroduodenoscopy (OGD), were required for seven patients (41%) due to persistent symptoms. Five of the 17 patients (29%) were readmitted due to complications, such as infections and bile leaks. Despite these issues, 88% of PCS patients reported improved quality of life post-surgery.

Our study found that 34% of patients experienced persistent symptoms of PCS following laparoscopic cholecystectomy. While most reported an improvement in quality of life, a significant number required additional investigations and readmissions. The findings suggest that PCS remains an under-recognized condition and further research is needed to identify its underlying causes and improve diagnostic protocols. Standardized diagnostic criteria and long-term follow-up could help in better managing these patients.