Gallbladder post op complaints

[Bobbi339]

I had a routine (?) lap gall bladder removal on March 12, 2003.  Five days later I was readmitted to the hospital with considerable pain and jaundice. Tests showed that a surgical clip was blocking the common bile duct.  Surgery was performed to correct this by choledocojejunostomy (sp?).
I am now six weeks post op and have noted the following problems:
1) clay colored stools
2) pain under right shoulder blade after eating
3) nausea after eating
4) intense pain under right side rib cage upon deep breath or yawning.
Do you have any comments or suggestions?

[Kevin Pho, MD]

Hello - thanks for asking your question.

It is certainly possible that there is a problem with the choledocojejunostomy.  A continued blockage can give you the symptoms of jaundice you are experiencing.  

I highly recommend going back to your original surgeon for followup and discuss these symptoms.  

If everything with the surgery was uncomplicated, post-cholecystectomy syndrome (PCS) is possible - it is reported in 10-15% of cases.  This simply means the presence of symptoms despite cholecystectomy.  A repeat ultrasound and possible ERCP or MRCP should be considered to further evaluate PCS.

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.

Thanks,
Kevin, M.D.

[Sunshine5270]

Welcome to the wonderful world of sick people with missing gallbladders.

I am being sarcastic because I had my gallbladder out for 1-1/2 yrs. now and STILL get the right shoulder blade pain, all the other things you have, and more stomach problems than I ever had. Do a www.google.com search for digestive problem forums, you will meet thousands of people like us, screwed since the gallbladder came out.

The only positive I can give you is you have to watch your fat intake (keep it minimum), watch your lactose intake (most are lactose intolerant after gallbladder removal), and keep the fiber going through your body.

Good luck

[surgeon]

it's possible the jejunostomy isn't emptying properly.
The place to go to find out what's actually going on is your surgeon's office; let him/her know what you are noticing. As to the people on this site screwed up after gallbladder surgery; it's among the most common operations done. If you have several hundred thousand procedures of a certain kind done, you will be able to find many who've had problems. They come in various groups: those who, like you, had a technical error occur during the surgery; those who have an uncommon but known side-effect; and those whose gallbladder in retrospect was not the cause of the symtoms for which the surgery was elected. I don't for a minute want to defend errors or say that gallbladder or any surgery is free of unhappy recipients. But I've done a couple of thousand gallbladder operations over my 30 or so years of being a surgeon, and have literally a handful of patients who wish they'd not had it done. And the same is true for hernia repairs, intestinal surgery, etc, etc.

[Bobbi339]

Thank you for your comments!

[tessa0825]

I would like to add  that most people that have positive outcomes dont normally post about it....It is the people that are looking for answers because they have had problems post op that seek out the support or message boards...The majority just recover and go on their merry way. When we are looking for answers we come here and only read about the negative...I have had no complications related to my GB removal but I do have other non GB related medical problems that keeps me searching for answers on these boards. When I can offer my support about a positive outcome then I try to do that....Its a shame that not everyone can be guaranteed to have a positive outcome but most things dont come with 100% guarantees.....To the original poster:....Im sorry that you have had such a hard time following your surgery and I hope you will soon feel better...........Tessa

[rainyb]

Does anyone have comments on age and gallstones? My 17 year old daughter was diagnosed with sludge and stones in February and has had 7 serious attacks since,she has elevated liver enzymes and I am very worried about recovery and long term damage. We are waiting for surgery.

[nadia]

A surgical clip was left inside? I may be just a layman, but is that supposed to happen?  If not, I would think that someone should be held accountable.

More people who have gallbladder attacks without stones should be informed by their doctors that removal may not always effect a cure. Don't be afraid to ask questions and do lots of research yourself.  I never knew that so many people had problems after the removal of their gallbladder and it isn't just on this site.  Just do a search on Post Cholecystectomy Pain Syndrome.

[nadia]

They left the clip in? Was that supposed to happen?  I may be just a layman but shouldn't someone be accountable for that?

More people should be informed by their doctors that removal of their gallbladder when no stones are present doesn't always effect a cure. Go into this surgery well informed. Ask questions and do the research on the internet.  If I had known about all the people who are having difficulties after their surgery, I may not have jumped into it like I did. And it isn't just on this site, just do a search on Post Cholecystectomy Pain Syndrome.

[lemonhead]

I have my gallbladder out in 1998 and have had absolutely NO problems associated with it. I think what surgeon and others have said is true -- that the internet (and bds like this one) are littered with stories of people who have problems with their procedures and are looking for answers. The people who have no problems with their procedures are just out there busy living their lives.

It's easy to get misinformed (and worried) about health issues when you search on the internet bc there is so much information out there from so many different sources. I always stick to reputable sites (like those from nationally known organizations, the NIH or similar) bc those will probably have the most accurate statistics.

Anyway, just wanted to say that there are THOUSANDS of people who don't have problems associated with their gallbladder being removed. You might want to take that into consideration as you ponder whether to have this surgery. Good luck with the decision.

lemonhead

[shaelynn]

I am sorry to hear about your problem. I would be hesitant to return to the surgeon that left a clip in me. can you get another opinion?  I had mine out 1  1/2 ago and have had nothing but problems since then. Chronic diarrhea, nausea, etc.  Please get another opinion and see what they say.

[BonnyT]

I believe surgeon and Dr. Kevin would tell you that a clip is always applied to the cystic duct portion that remains after surgery. The problem here was as surgeon stated, a technical error occured and the clip was applied to the common bile duct instead. Please continue to follow up on this. Injuries to the common bile duct are rare during a lap cholecystectomy but I believe are directly related to the learning curve and experience of the surgeon. Also no one should continue to suffer with chronic diarrhea after this procedure, there are medications that can help. I have absolutely no studies to support this but firmly believe adequate hydration (water) will help keep bile more dilute and may prevent some of these post cholecystectomy problems. Read "Your Body's Many Cries For Water" by a physician, it is an intersting book. I made the very difficult decision that surgery was the best option even after one episode of biliary colic when US revealed a large free floating stone. Only about 30% of folks will escape furthur problems but it was still very frightening since I am fortunate to have good health and feel great on most days of my life. This was on Good Friday and I did attend church on Easter Sunday with my family. So far all is well. I did decline to go to a teaching hospital but instead to a very experienced surgeon in a private hospital. I know residents need to learn but I felt I could decrease my risks of bile duct or other injury by insuring that only my surgeon would do my procedure..

[Bobbi339]

Your comments and suggestions have been very helpful. I don't feel that I am alone with this problem.  I am following up on this with my doctors.  Thanks to all.

[zenon]

I am 3 years out of GB surgery and I have suffered for almost all 3 of those years with nauseau, dry heaves, pain in upper left abdomen. And diarrea (diarrhea) after the first meal of the day. I had endoscopy, CT scan, Ultrasound, all to be told I have gastritis and the diarrea (diarrhea) is "abnormally normal" for some after surgery and to learn to live with it.  I have been having some really good months now, and am still learning which foods to avoid to keep those symptoms at bay.  Keep your chin up, hopefully, those symptoms will disappear with time.  It is tiresome, but eventually, hopefully, you WILL fell better.

[schaeff]

Your comment about water is interesting. I had the lap choly 4 years ago, and every day since, I get excruciating, disabling epigastric pain 2-3 hours after every meal. Examined by three separate gastro specialists. Had every scope,scan and blood test, including an MRCP, except the ERCP - all normal. PPIs and H2 blockers had no effect. I therefore have a presumptive diagnosis of sphincter of oddi dysfunction, type III (biliary side). What is really weird, and what I've never heard anyone else mention, is that I can completely and nearly immediately eliminate the pain by drinking a glass of water and it works every time without fail!!!

[jay c]

My wife had her gallbladder removed in 1994. She has had infrequent pains on her right side since then, and Soma has controlled it fairly well. But last year she was in a car accident. Since then flair-ups have become an almost every-day occurrence. Pain medications don't do anything except at such high doses that she becomes incapacitated. Soma still works, but she has a tendency to take too much if the pain is severe,  I'm not comfortable with the idea of her being dependent on this (or any) medication for the rest of her life. I looked at levsin, but the side effects sound worse even than most pain medications. From what I've gathered by reading this forum and other web sites, there is medically nothing that can be done. Just eat a low-fat, high-fiber diet, drink lots of water, and learn to live with it. Is that really the only answer?

[krisg]

I drink only water and have so my whole life.  I still get the biliary colic even after having a generous biliary sphincterotomy done.  The glass of water does nothing for me when the pain hits.  Usually it hits so hard and fast that I barely have time to think.  I do take Donnatal for spasms.  Sometimes it works and sometimes it doesn't.  I took Levsin faithfully for 2 years until I had 2 attacks within one week and landed in the hospital on demoral.  I feel that the sphincterotomy did help somewhat because my attacks now are alittle less painful and the duration is only maximum 2 hours.  My bile duct has a high grade of stenosis.  Just found that out when I had the sphincterotomy in 2/03.  When I had my gallbladder out in 1998, I was diagnosed with stones. The gallbladder attacks I had then don't even compare to the attacks I have now.  On the good side, both my mother and best friend had their gallbladders taken out and have been fine for years.  It is a chance you take, as with any surgery.

[marlow]

I had my GB out nearly 4 years ago and my life has been a nightmare ever since.  I have constant D, without medication it can be 10-12 times a day - which obviously means I have no chance of going far or different.  I have terrible pains when I eat and have about 10 seconds to get to the toilet - which can be very embarrasing to say the least.  My doctor has told me that the only way this will change is if I have a baby then my bowels may alter.  Sorry, but I'm not having a baby just to stop me going to the toilet!!  I have been on Colestid for the last 3 years and in the Uk this is only available in sachet form which is taken with water - this is absolutely vile.  I would love to find out if it is going to be available in the UK in tablet form so if anyone out there can help it would be much appreciated.

[marlow]

Also, approximately 6 months ago I started vomitting frequently.  No warning, I just do it! Any ideas, could it be related to the rest of my symptons, bearing in mind it has really only just started.  I had blood tests for the sickness including Hepatitis screening and my Dr told me everything was fine except that my liver enzymes were high.  I had a repeat test a week later and although the enzyme level had dropped, it was still relatively high.  He said, in view of the tests being mainly OK, there was basically nothing wrong and had the attitude of 'go away now, you're OK'.  I now feel stupid going back as I feel he knows best & if he says I'm OK, then he must be right.  Any suggestions??????????

[bets1101]

My friend just had her gallbladder removed...by lap...this is her second day since surgery and she has not been able to eat yet...wondering if this is normal

[krisg]

I can relate to your story.  I would suggest getting another dr.  There are anti-spasm meds. that you can take as maintenance that will help ALOT with the bathroom problem.  Another thing, elevated liver enzymes are nothing that should be taken lightly! I have elevated liver enzymes only when I have an attack of biliary pain.  (I have a history of Sphincter of Oddi and bile duct problems since my gallbladder surgery 5 years ago). The sphincter clams shut and doesn't open, therefore the bile backs up into the liver and spills over into the blood stream.  That is only one reason for elevated liver enzymes.  There are many other reasons for elevated liver enzymes too.  Get a new doctor who is willing to work with you to find out your problem.  Good Luck.

[imurhucklbery]

test

[imurhucklbery]

i am slightly unusual in my complications from surgery greatly differ from those posted. hopefully somone might have some compassion or insight as to what the causes of my post op gb surgery could be and possibliy ideas on treatment.
i am quickly approaching my wits end. i am a 28 year old male with no family history of gallbladder disease, however abdominal cancer as well as many other cancers are prevalant in my family history.
my problems started 3 months ago, nauseau, vomiting blood and stomach acid, total food intolerance, and severe pain increasing as time went on, right upper quadrant, right shoulder, fever for over two months. after being turned away by almost every ER Dr, finally Dr byrd had the compassion and insight to further investigate my symptoms. after x-rays, unltrasounds, and lab work, he informed me that i would not leave the hospital, and would be admitted immediately. he scheduled me for surgery the following day, as it was considered life threatening in nature.
the surgery took almost 2 and 1/2 hrs, afterwards i remained in the hospital for 3 days. my gallbladder was the size of a orange, and contained 3 extremely large stones sizes of quarters, along it many smaller stones, and was highly infected.
i recived cipro 2 times a day as i was running a high fever, upon discharge, my fever still remained 101.7  my surgery was 7 weeks ago, i still have a high fever on a daily basis, altho i have modified my diet and lifestyle, in an attempt to cope with these complications... so far all remain unsuccessful. for almost 4 weeks i have been removed off my pain meds and am still in dire pain. i am so exhausted from the non-stop fever and pain it is hard to imagine continuing like this. i can only eat about
once every three days, and then i have severe nauseau, and vomiting, followed by two plus days of greenish/yellowish stool, stagnat, containing no fecal matter what so ever. it has to be stomach acid/bile and it burns my rectum raw. this also is excrutiatingly painful. i take reglan for nauseau, and prevacid to attempt to control the amount of stomach acid/bile i am producing... both approaches remain unsuccessful in curing my ailments. what could be causing these painful complications, vomiting, rectal discharges, massive headaches, and the presistant pains in my right quadrant, and back/ shoulder pain...
they all but keep me incapacitated, curled into a fetal position for 6-8 hrs a day.  
what can i do?  what could it be?  help please...
i fear i am loosing my mind at times.

[angelgal]

I posted a similar response above but thought someone might see this here too.  I had a lap chole May 22, 2003. At first things seemed to be moving along fine, but the past few days, I am having almost constant pain, nausea, and discomfort. Anything I eat makes me feel sick. I also have Celiac Disease but do not think this would have any effect on the outcome of my surgery. Does anyone have any ideas on what might cause these after-effects or has anyone had a similar experience? I do have my two-week post-op appt Thursday.

[Sheillah]

I had my gallbladder taken out on May 15, 2003.  After a few days I started feeling great.  When the second week started, I felt awlful.  I had (& still have) serious pain in the same spot my gallbladder was.  I have been running a low fever on and off.  I have chills and then feel like I'm burning up.  My skin is a pasty white color and I am soooooo exhausted.  I also have diaherea (sp?) all the time.  I am eating OK, but losing weight.
I had a blood test yesterday and my liver values are up and my RBC count is down.  Is this normal?
I have an  doctor's appointment this afternoon.

[bets1101]

My friend had Gallbladder out by LAP on May 14...she is nauseated most of the time and has diarrhea shortly after eating...every time she eats. Her surgeon said that this should let up in 3 to 4 weeks...we are now getting close to the 4th week and it goes on...my concern is that the stools are "clay colored" I am wondering if this is normal..she has no fever or juandice...just the nausea and clay colored diarrhea soon after she eats...she does not see her Dr for a week..should she wait or is there something to be concerned about?

[marlow]

My advice would be to go straight back to the doctor.  Waiting a week won't help.  I've been like that for 4 years and it's still not letting up.  I have been waiting for a review appointment at the hospital for the last 18 months and have always been told I'm on the list of patients waiting to be seen.  I received a letter today and now have an appt on 1 July.  After reading all of these comments, I will definitely have some great ammunition for the consultant.  I'll let you all know the outcome.  You never know, this time he might just prescribe a miracle cure!! (I wish)!!!!!!!!

[angelgal]

I had my f/u appt last week.  I was told to "wait out" the nausea another couple weeks and see if I can find a pattern.  I already have one...every time I eat, I feel sick!  To add insult to injury, while on vacation last weekend, my upper incision broke open.  I was seen today and had one of the internal sutures coming out.  That is what broke the incision and now I have an infection to go with it.  Still no answer on the nausea or the pain.

[Cuppy11]

A related discussion, back pain was started.