Volume 29, Issue 162, August 2025

Postcholecystectomy syndrome - management and treatment

Michał Korpalski^1♦, Maria Pawluczyk², Krzysztof Pawlikowski³, Marek Żygłowicz⁴, Adam Torbicki⁵, Dominik Augustyn⁶, Piotr Gaworek⁷, Mateusz Marciniak⁸, Alicja Trybuła⁹

¹Dr. Tytus Chałubiński Radom Specialist Hospital, Adolfa Tochtermana 1 Street, 26-610 Radom, Poland
²District Hospital in Sochaczew, Batalionów Chłopskich 3/7 Street, 96-500 Sochaczew, Poland
³University Clinical Center of the Medical University of Warsaw, Banacha 1A Street, 02-097 Warsaw, Poland
⁴Ludwik Rydygier Specialist Hospital, Złota Jesień 1 Street, 31-826 Kraków, Poland
⁵Nicolaus Copernicus Hospital, COPERNICUS Medical Entity limited liability company under Polish law, Nowe Ogrody 1/6 Street, 80-803 Gdańsk, Poland
⁶Ludwik Rydygier Specialist Hospital, Złota Jesień 1 Street, 31-826 Kraków, Poland
⁷Międzyleski Specialist Hospital in Warsaw, Bursztynowa 2 Street, 04-749 Warsaw, Poland
⁸Mikołaj Kopernik Provincial Multi-Specialist Center of Oncology and Traumatology Pabianicka 62, 93-513 Łódź, Poland
⁹Kazimierz Pułaski University of Technology and Humanities in Radom: Radom, Mazovia, PL Jacka Malczewskiego 29, 26-600 Radom, Poland

^♦Corresponding author
Michał Korpalski, Dr. Tytus Chałubiński Radom Specialist Hospital, Adolfa Tochtermana 1 Street, 26-610 Radom, Poland

ABSTRACT

Gallstones are described as one of the most common diseases of the digestive system. It can affect 15% of the adult population. The standard of treatment for symptomatic gallbladder stones is laparoscopic cholecystectomy. Among its most outstanding features are its effectiveness and low complication rate. In a proportion of patients, the image of side effect, with a name known as Postcholecystectomy Syndrome (PCS), occurs after a successful surgery, for some time, with medical implications. In the context of PCS, a variety of clinical symptoms are included, including diarrhea, abdominal pain, nausea, indigestion, or bloating. It may be immediately following an operation or many months or years afterwards. The etiology of PCS is complex and ambiguous, including both organic causes (e.g., residual stones, sphincter of Oddi dysfunction), and extra-biliary causes (e.g., irritable bowel syndrome). The variety of symptoms and causes makes the diagnosis of PCS difficult and requires a multidisciplinary approach. This paper will provide an overview of the current state of knowledge on PCS, with a focus on the mechanisms of symptom onset, diagnostic options and available therapeutic strategies, including the treatment of diarrhea caused by bile acid disorders.

Keywords: postcholecystectomy syndrome (PCS), laparoscopic cholecystectomy, bile acids, postoperative diarrhea, sphincter of Oddi dysfunction

Medical Science, 2025, 29, e140ms3670

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DOI: https://doi.org/10.54905/disssi.v29i162.e140ms3670

Published: 21 August 2025