Nam Changjin, Lee Jun Suh, Kim Ji Su, Lee Tae Yoon, Yoon Young Chul
Kyungpook National University Medical College, Daegu, Republic of Korea.
Department of Surgery, Bucheon Sejong Hospital, Bucheon, Republic of Korea.
Ann Med. 2025 Dec;57(1):2496408. doi: 10.1080/07853890.2025.2496408. Epub 2025 Apr 30.
Post-cholecystectomy syndrome (PCS) is a complex condition characterized by persistent or new symptoms following gallbladder removal, affecting up to 47% of patients. Despite being recognized since 1947, there is still no consensus on its etiology, diagnosis, and treatment.
This narrative review explores the multifactorial etiology of PCS, including biliary and extra-biliary factors, and its varied clinical manifestations. A systematic literature search was conducted using keywords like 'etiology', 'clinical manifestations', 'diagnostic challenges', and 'management strategies'. The review covers traditional diagnostic methods, recent insights into pathophysiology, and current management approaches, such as dietary modifications, pharmacological treatments, and endoscopic interventions, with a focus on patient selection.
PCS presents significant clinical challenges due to its diverse presentations and lack of standardized diagnostic and therapeutic protocols. Effective management starts with careful patient selection before cholecystectomy to prevent unnecessary surgeries and reduce postoperative complications. Future research should aim to refine diagnostic criteria and develop predictive models for identifying at-risk patients. Personalized management strategies incorporating genetic, biological, and clinical factors are essential for improving outcomes. An integrated, patient-centered approach is crucial for addressing PCS complexities and enhancing the quality of life for affected patients.
胆囊切除术后综合征（PCS）是一种复杂的病症，其特征为胆囊切除术后持续存在或出现新的症状，影响高达47%的患者。尽管自1947年以来就已被认识到，但在其病因、诊断和治疗方面仍未达成共识。
本叙述性综述探讨了PCS的多因素病因，包括胆道和非胆道因素，以及其多样的临床表现。使用“病因”、“临床表现”、“诊断挑战”和“管理策略”等关键词进行了系统的文献检索。该综述涵盖了传统诊断方法、对病理生理学的最新见解以及当前的管理方法，如饮食调整、药物治疗和内镜干预，并重点关注患者选择。
由于PCS表现多样且缺乏标准化的诊断和治疗方案，它带来了重大的临床挑战。有效的管理始于胆囊切除术前仔细的患者选择，以防止不必要的手术并减少术后并发症。未来的研究应旨在完善诊断标准并开发用于识别高危患者的预测模型。纳入遗传、生物学和临床因素的个性化管理策略对于改善治疗结果至关重要。一种综合的、以患者为中心的方法对于应对PCS的复杂性和提高受影响患者的生活质量至关重要。
