hepatic and biliary disorders
Postcholecystectomy Syndrome
Diagnosis of Postcholecystectomy Syndrome
Endoscopic retrograde cholangiopancreatography (ERCP) with biliary manometry or biliary nuclear scanning Exclusion of extrabiliary pain Patients with postcholecystectomy pain should be evaluated as indicated for extrabiliary as well as biliary causes. If the pain suggests biliary colic, alkaline phosphatase, bilirubin, ALT, amylase, and lipase should be measured, and ERCP with biliary manometry or biliary nuclear scanning should be done (see Laboratory Tests of the Liver and Gallbladder and Dysfunction is best detected by biliary manometry done during Endoscopic retrograde cholangiopancreatography (ERCP) , although ERCP with biliary manometry can induce pancreatitis in up to 25% of patients ( 1.Maldonado ME, Brady PG, Mamel JJ, et al: Incidence of pancreatitis in patients undergoing sphincter of Oddi manometry (SOM).Am J Gastroenterol94(2):387-390, 1999. doi: 10.1111/j.1572-0241.1999.00864.x 