post surgery stones

[painpillhead]

Hello.  I am experiencing a dull pain on my right side, and in my back area by my right shoulder blade.  I had my gallbladder removed in Aug 2002 due to gallstones, and I am still very tender in this area.  I am going to doc on Monday and will they will do a sonogram.  I don't have fever, I am not yellow...If there is/are stones in the duct, what is done to treat this?
I also am being treated for Hep C and have just finished up a 6 month treatment (yesterday) with PegIntron/Rebetol.  Could this be a reason for mild pain?
thank you.
Lori

[Kevin Pho, MD]

Hello - thanks for asking your question.

Pain after cholecystectomy is a known entity (please see my previous answers regarding Post-cholecystectomy syndrome).  

If there are stones remaining in the duct, a procedure known as an ERCP is commonly done by a gastroenterologist.  This will identify and remove stones in the duct.  If, after a complete evaluation (including an ERCP with sphincterotomy), a patient continues to have debilitating, intermittent RUQ pain, and no diagnosis is found, the procedure of choice after a normal exploratory laparotomy is a transduodenal sphincteroplasty.

Here are some adverse effects of PegInterferon from the Drug Information Handbook:
"ADVERSE REACTIONS >10% : Central nervous system: Headache (56%), fatigue (52%), depression (16% to 29%), anxiety/emotional liability/irritability (28%), insomnia (23%), fever (22%), dizziness (12%), impaired concentration (5% to 12%), pain (12%) Dermatologic: Alopecia (22%), pruritus (12%), dry skin (11%) Gastrointestinal: Nausea (26%), anorexia (20%), diarrhea (18%), abdominal pain (15%), weight loss (11%) Local: Injection site inflammation/reaction (47%), Neuromuscular & skeletal: Musculoskeletal pain (56%), myalgia (38% to 42%), rigors (23% to 45%) Respiratory: Epistaxis (14%), nasopharyngitis (11%) Miscellaneous: Flu-like syndrome (46%), viral infection (11%)"

As you can see, abdominal pain is a potential adverse effect.  However, there are plenty of other reasons for RUQ pain and this should be explored with your personal physician.  I strongly suggest followup.

I stress that this answer is not intended as and does not substitute for medical advice - please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.

[surgeon]

in most cases stones in the duct after gallbladder surgery can be removed fairly simply by passing a scope through the mouth, into the stomach and intestine, and finding the duct where it joins the intestine. The stone can be extracted that way; it is "non surgical" and usually doesn't require overnight in the hospital.

[painpillhead]

thank you both so much for you answers...It really helped.
Lori

[Hyena of Ice]

That's generally what they do if the gallstone is near the mouth of the bilary duct.