Phantom gallbladder pain is commonly due to post-cholecystectomy syndrome. It occurs when symptoms around the gallbladder mimic cholecystitis pain but stem from a different cause.

The gallbladder is a small, hollow organ that resembles the shape of a pear. It forms part of the biliary system, alongside the liver and pancreas, leading into the small intestine. The gallbladder stores bile, which is a fluid the liver makes that facilitates fat digestion and cholesterol excretion. Bile may also possess antimicrobial properties.

Phantom gallbladder pain, which can occur as part of post-cholecystectomy syndrome, refers to a diverse group of symptoms that mimic those a person may experience before a cholecystectomy, or gallbladder removal surgery. Cholecystectomy is a common treatment for gallstones and issues they may cause, such as cholecystitis.

Post-cholecystectomy syndrome may manifest with symptoms similar to biliary colic or pain in the right upper quadrant of the abdomen with a range of gastrointestinal symptoms. Research indicates that around 10–15% of people who undergo cholecystectomy surgery may experience post-cholecystectomy syndrome.

This article discusses possible causes of phantom gallbladder pain and other symptoms of post-cholecystectomy syndrome. It also explores the diagnosis and treatment of post-cholecystectomy syndrome and when to consult a doctor.

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Different causes can result in phantom gallbladder pain. Typically, healthcare professionals use post-cholecystectomy syndrome as a temporary conclusion until a more thorough diagnosis reveals the underlying cause of any symptoms.

Often, there is no obvious cause of phantom gallbladder pain. However, some researchers suggest that most people experience symptoms due to an underlying condition that may have existed before the cholecystectomy procedure.

Other researchers suggest that the most common identifiable cause is an extra-biliary disorder that a medical professional has overlooked. Extra-biliary disorders affect areas outside the biliary tract and may include:

Biliary issues that may cause post-cholecystectomy syndrome include:

  • bile-salt induced diarrhea
  • retained calculi, which refers to gallstones that remain in a person’s body following cholecystectomy
  • abnormal narrowing of the bile duct
  • cystic duct remnant, which is when gallstones remain in a cystic duct following cholecystectomy
  • abnormal narrowing of the cystic duct
  • bile leak
  • sphincter of Oddi dysfunction

A bile leak may occur as a complication of cholecystectomy, including an accidental cut in the bile duct or if the clips or ligatures that seal the tube connecting to the gallbladder come off.

Healthcare professionals may perform an upper gastrointestinal endoscopy to help identify the cause behind early post-cholecystectomy syndrome symptoms.

Healthcare professionals use the term post-cholecystectomy syndrome to describe symptoms that are often similar to those that occur before cholecystectomy surgery, such as biliary cholic. However, the most common issues are indigestion or nonspecific symptoms rather than true biliary colic.

A 2018 study of 272 participants found the main symptoms of post-cholecystectomy syndrome other than phantom gallbladder pain included:

Symptoms may vary depending on the underlying cause.

Treatment for post-cholecystectomy syndrome depends on the underlying cause, so a healthcare professional will make a diagnosis before creating a treatment plan.

Practitioners often use the following diagnostic tests when assessing the cause behind post-cholecystectomy syndrome:

Other diagnostic tests may include X-rays or ultrasound scans.

Treatments for post-cholecystectomy syndrome may include medications or procedures.

Medications may include the following, depending on the cause of symptoms:

Other treatment options may include the following surgical procedures:

A person should consult a doctor if any symptoms develop after cholecystectomy surgery. Other complications of a gallbladder removal surgery may include:

  • Mirizzi syndrome, which is when a stone forms and obstructs the hepatic duct, which leads to the liver
  • cholangitis, where there is inflammation of the bile duct
  • biliary stent blockage or movement

Additionally, symptoms may be a sign of an infection. In this case, symptoms may include severe pain, inflammation, and pus. People should speak with a healthcare professional if they think they have an infection.

Phantom gallbladder pain can occur following cholecystectomy surgery as a symptom of post-cholecystectomy syndrome. Often, symptoms result from an underlying condition that was present before the gallbladder removal procedure.

To treat post-cholecystectomy syndrome, healthcare professionals determine the underlying cause. They will then use the diagnosis to make a treatment plan.

A person should speak with a doctor about possible symptoms following a gallbladder removal surgery. By understanding potential complications and the possible signs and symptoms, people may find it easier to identify if they experience any issues.

People should contact a doctor as soon as possible if any unexpected symptoms develop following a cholecystectomy procedure.