[The so-called postcholecystectomy syndrome in light of the results of endoscopic retrograde cholangiopancreatography].

The term "postcholecystectomy syndrome" indicates etiologically and pathogenetically various lesions of the organism related to variably expressed symptoms of pain and dyspepsia. The author has performed endoscopic retrograde cholangiopancreatography (ERCP) to 60 patients with "postcholecystectomy syndrome" to find out what underlies this syndrome. In 34 (56%) of the patients the biliary ducts were dilated. The most frequent cause of this was Vater's papilla stenosis, which was found in 26 patients (43%). The author is of the opinion that this stenosis preceded the cholecystectomy and was the result of inflammatory processes related to cholelithiasis. In 20 patients stones were found in the biliary ducts, single or multiple. In most cases the stones in the biliary duct had been missed during the cholecystectomy. In some patients the stones in the biliary duct were formed after the operation. In 26.6% of the patients ERCP helped in discovering other diseases such as chronic pancreatitis, duodenal ulcer and peripapillary diverticulum which are in the basis of the "postcholecystectomy syndrome". The author recommends to every patients with persistent complaints after cholecystectomy ERCP to be performed in order to find out the cause of the complaints and determine the correct treatment--medicamentous or surgical.