Post Op problems

[cmcleroy]

I am a 24 year old female and had a laparoscopic cholecystectomy  5 days ago due to a diagnosis of gallbladder disease using the HIDA scan. My gallbladder's refraction was 2%.  The operation went fine and I was feeling okay until day 4.  My lower right side of my stomach started hurting and the pain increased so bad that I ended up in the ER.  They did blood work, urine test and a CT.  They ruled out all serious causes such as infection, stones in the bile duct, et.  They sent me home with more pain meds.  However I am still in severe pain.  The pain now on a scale from 1 to 10 is about a 6 (yesterday it was a 10).  Is this normal?  My surgeon was consulted by the ER doctor and they seem to think maybe I passed a gallstone or it was just gas.  This pain was so intense I almost passed out and lasted for about 45 minutes at a time.  If this pain continues what should I do next?  The ER doctor said I could come back if the pain got worse, but what else can they do to find out what is going on?  I am really at a lost as to what to do next.  I have never had any surgeries before and everyone I talked with said that gallbladder surgery is easy  to recover from, so this is very unexpected. This pain is not like the pain I had before my gallbladder was removed, it is very sharp and lasts for a long time.   If I did pass a gall stone I feel like I should not be hurting like this any longer.  Please give any advice.

[cmcleroy]

To let everyone know, since my last post I have been in the hospital.  The GI specialist did a ERCP and found a bile leak.  This was fixed with a stent which has to be removed in one month.  The ERCP caused acute pancreatitis.  I have been on massive anti-botics, pain meds, glucose and no food.  The leak  was very small and very little bile entered my system so no drainage was necessary.  The ERCP took 3 1/2 hours which was extremely long and in which I awoke at the end and knew I had a tube down my throat.  I have been released from the hospital and am feeling much better but I dread the removal of the stent.   I am still wondering if someone messed up or is a leak something that cannot be forseen in some situations.  I still do not know the long term affects of what happened to me and I guess time will tell.  To let everyone know, if you feel sharp pain days after a gallbladder removal insist that test be run.  If I had waited any more days, sepsis would have set in and I may not have made it.

[GhostOf1901]

While there's no definitive answer to your question, there are a number of possibilities. GIven my limited knowledge of the subject matter, the first thing that comes to mind is possible SOD (Sphincter of Oddi Dysfunction). While uncommon, this is sometimes seen in cases of gallbladder dyskinesia. This is a condition where the sphincter which controls bile getting out to the small intestine isn't functioning well. Unfortunately, not many doctors have experience with this, and some don't even believe it exists, so you have to proceed with extreme caution. You might be asked to get an ERCP done to find out whether this is the case. (If so, ask whether an MRCP would be  fine. While rare, one of the possible consequences of an ERCP acute pancreatits.) You can read more detailed information here:

http://sod-stinks.blogspot.com/2007/05/article-by-walter-j-hogan-md_04.html

It's long, it's somewhat boring, but it's also very informational. Here's a small excerpt:

    * SOD is most commonly recognized in patients who have undergone Cholecystectomy (hence the name postcholecystectomy syndrome).

    * The reasons for this are not well understood, but may be related to unmasking of preexisting SOD due to removal of the gallbladder, which may have served as a reservoir to accommodate increased pressure in the biliary system occurring during sphincter spasm [7].

    * Another possible explanation is alteration of SO motility due to the severing of nerve fibers that pass between the gallbladder and SO via the cystic duct [8].

    * However, SOD also occurs in patients whose gallbladders are intact, suggesting that other pathophysiologic mechanisms are involved [9].

P.S.
I'm in a similar boat. My EF was 19%. No stones. I'm investigating now the possibility of SOD.

Good luck.

[jenves]

I have no answers or advice for you-as I am on day 3 post-op lap cholecy(my first surgery as well).  Yesterday I couldn't even stand without vomiting-my MD called me in some phenergan, and today I have actually been horizontal some.  But I am having more pain than I expected-keep us posted as to how you are feeling.  I think mine is more in regards to the anesthesia.  Good Luck.