Post Cholecystectomy Syndrome (PCS) - Imaging findings in Biliary causes

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Post Cholecystectomy Syndrome - Imaging findings in Biliary causes

A complex of heterogeneous symptoms ( upper abdominal pain & dyspepsia) which recur or persist after cholecystectomy.

Consists of both biliary and extra biliary disorders

Biliary Manifestations:  

Early Onset: 

- Incomplete surgery ( retained calculi in cystic duct or CBD)

- Operative complications: bile duct injury / bile leakage 

Late onset:

- Inflammatory strictures involving the sphincter of oddi / CBD

- recurrent calculi (cystic duct / CBD / GB remnant)

- Biliary dyskinesia

Imaging of choice: MRCP

Sequences:

1. 2D SLAB MRCP

2. 3D MRCP

3. Optional: High resolution thin T2 W axial images


References:

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3473449/

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