Bile Duct Damage and Gall Bladder Surgery

[richie421]

My husband has suffered from post gastrectomy syndrome since 1972. He had laproscopic gall bladder surgery in February 2005 and has had chronic problems since.  He has had nauseau, enlarged liver, leg swelling, loss of muscle, rashes, weight loss, confusion.  He recently had a liver biopsy and was diagnosed with stage 2 cirrhosis.  He drinks some alcohol but has only been drinking for about 18 months.  He is scheduled for an MRI on the bile ducts to check for blockages because he has bile back up in the liver.  We asked the doctor early on when his liver began to swell if this could be caused by the gall bladder surgery and were assured that gallbladder surgery is very routine and probably has not caused the problem.  I looked up the risks for laproscopic gall bladder surgery and found that bile duct damage happens in a small percent of surgical procedures. If he had bile duct damage that took place in February 2005, could he have sustained enough liver damage in 5 months to have caused his liver to reach stage 2 cirrhosis?  Could alcohol have caused the cirrhosis in just 18 months? I am concerned with the length of time that has passed and more damage.  Should we seek a liver specialist?

[Kevin Pho, MD]

If there is evidence of cirrhosis, a referral to a liver specialist may not be a bad idea.  

Scarring of the biliary duct is possible with a cholecystectomy, however if this symptom is serious enough to lead to cirrhosis, this would be a very atypical presentation.  

Alcohol is certainly a factor, however it would be unlikely that 5 months of drinking will lead to cirrhosis.  

I would check for hepatitis if it hasn't been done already.  Unfortunately, there is no proven cure for cirrhosis short of a liver transplant.  

This conditions should be discussed with a gastorenterologist or liver specialist.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
http://www.straightfromthedoc.com

[surgeon]

It could be due to any or all: a bile duct injury, alcohol, liver damage worsened by anesthesia, or entirely different factors. Investigating the anatomy of the bile ducts is an important thing to do, although it's likely that if there were surgical damage of the sort that would cause his problems, ultrasound ought to show it, too. I assume his post-gastrectomy anatomy is what's preventing an attempt at ERCP (placing a scope in the bile duct via the intestine.)