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Gastroenterology (Expert Forum)
ERCP following gallbladder surgery
Answered by
Kevin Pho, MD - Internal Medicine
Kevin, M.D.
Boston - MA
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
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ERCP following gallbladder surgery
by confetti, Oct 03, 2003 12:00AM
I had my gallbladder removed laporoscoply. I was sent home the next day. 3 days later I began having severe pain. I called my surgeon who said that pain is normal and recommended vicodin. I called back a few hours later, on Sunday night, she was oncall. Again I was told pain is normal. I told her it didn't seem normal and was worse than the gall bladder attacks that led to the surgery. She recommended another vicodin and rest and seemed annoyed that I'd bothered her.
Monday morning the pain was incredible. I called her office at 9:00 A.M. Her staff passed on my message and again recommended rest and vicodin. After my 3rd call they ordered blood work. I called several more times and was reassured but not seen. Finally shortly before 5:00, as the office was closing I was sent to urgent care. By the time I got there I had to be taken in by wheelchair. After several hours and tests I was admitted to the hospital and told an ERCP would be performed the next morning. I was given a sleeping pill and morphine for the pain. This was Monday night, I was given morpine by the nurses and was not allowed anything by mouth as ERCP was in the A.M. By Tuesday evening no one had done the ERCP. I asked and was told it would be done Wed. A.M. Again nothing by mouth and lots of morphine. This continued until Friday when they finally attempted the ERCP. I had been waiting, in hospital 4 days. By this point the stone was lodged at the bottom of the common bile duct and was severly inflamed. After trying for several hours they stopped and scheduled a new ERCP for Monday. I was kept through the weekend with morphine for the pain. Finally Monday afternoon, another ERCP was performed, this time successfully but by now my liver enzymes were severly elevated, my bilirubin was at 800 and I was very jaundiced.
I came home with severe itching which lasted for 5 months. My primary care doctor prescribed medication for the itching which helped somewhat.
I never saw my original surgeon again. I asked when I should have my followup and was told to see my family DR. I only saw her once during my 8 day hospital stay. I feel abandoned. What is normal following gallbladder surgery? Shouldn't she have seen me that Monday instead of waiting until the end of the day and sending me to urgent care? Is it normal to wait 4 days, in excruciating pain, in a hospital bed, for an ERCP?
Monday morning the pain was incredible. I called her office at 9:00 A.M. Her staff passed on my message and again recommended rest and vicodin. After my 3rd call they ordered blood work. I called several more times and was reassured but not seen. Finally shortly before 5:00, as the office was closing I was sent to urgent care. By the time I got there I had to be taken in by wheelchair. After several hours and tests I was admitted to the hospital and told an ERCP would be performed the next morning. I was given a sleeping pill and morphine for the pain. This was Monday night, I was given morpine by the nurses and was not allowed anything by mouth as ERCP was in the A.M. By Tuesday evening no one had done the ERCP. I asked and was told it would be done Wed. A.M. Again nothing by mouth and lots of morphine. This continued until Friday when they finally attempted the ERCP. I had been waiting, in hospital 4 days. By this point the stone was lodged at the bottom of the common bile duct and was severly inflamed. After trying for several hours they stopped and scheduled a new ERCP for Monday. I was kept through the weekend with morphine for the pain. Finally Monday afternoon, another ERCP was performed, this time successfully but by now my liver enzymes were severly elevated, my bilirubin was at 800 and I was very jaundiced.
I came home with severe itching which lasted for 5 months. My primary care doctor prescribed medication for the itching which helped somewhat.
I never saw my original surgeon again. I asked when I should have my followup and was told to see my family DR. I only saw her once during my 8 day hospital stay. I feel abandoned. What is normal following gallbladder surgery? Shouldn't she have seen me that Monday instead of waiting until the end of the day and sending me to urgent care? Is it normal to wait 4 days, in excruciating pain, in a hospital bed, for an ERCP?
Doctor's Answer
by Kevin Pho, MD, Oct 07, 2003 12:00AM
, Oct 07, 2003 12:00AM
As I you can understand, I cannot comment specifically on your case as to what should or shouldn't have been done.
Retained common bile duct stones happen in approximately 10 precent of cases. Bile duct injury can occur in as high as 5 percent of cases, dependent on the experience of the surgeon.
Regarding a normal course of laparoscopic cholecystectomy, the usual hospital stay is eight to twenty-four hours, and most patients are able to return to their normal activities within five to seven days.
If you are not comfortable with the care you received, you may want to consider changing to another physician. It is not typical that you had to wait days before appropriate treatment was rendered.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
Retained common bile duct stones happen in approximately 10 precent of cases. Bile duct injury can occur in as high as 5 percent of cases, dependent on the experience of the surgeon.
Regarding a normal course of laparoscopic cholecystectomy, the usual hospital stay is eight to twenty-four hours, and most patients are able to return to their normal activities within five to seven days.
If you are not comfortable with the care you received, you may want to consider changing to another physician. It is not typical that you had to wait days before appropriate treatment was rendered.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
Member Comments (6)
by krisg, Oct 04, 2003 12:00AM
Sorry but I have to post. Severe pain after gallbladder surgery is NOT normal! I was told the same thing by the nurse who spent half the night with me while I was in severe pain and vomiting. All of wich happened after the surgery. I was kept an additional day in the hospital and the surgeon came in and said I had a bad night. 5 years later and I finally am on some sort of road to recovery. Stones left in the bile duct are very common after gallbladder surgery. Here I am 5 years later and I have another stone in my bile duct! Go figure!! My sugestion would be, GET ANOTHER DOCTOR
by krisg, Oct 04, 2003 12:00AM
Sorry but I have to post. Severe pain after gallbladder surgery is NOT normal! I was told the same thing by the nurse who spent half the night with me while I was in severe pain and vomiting. All of which happened after the surgery. I was kept an additional day in the hospital and the surgeon came in and said I had a bad night. 5 years later and I finally am on some sort of road to recovery. Stones left in the bile duct are very common after gallbladder surgery. Here I am 5 years later and I have another stone in my bile duct! Go figure!! My sugestion would be, GET ANOTHER DOCTOR. I had to go through a couple of gastro. doctors and specialists until I found one that is very attentive and very intelligent in the bile duct area. Of course there can be other problems as well, after any surgery. The dr. was wrong to put you off. Bile duct stones can be life threatning, if left untreated.
by Della1234, Nov 26, 2003 12:00AM
I just had Laproscoptic surgery I had my GallBladder removed on Tuesday Nov.18,2003 and I have been in so much pain.My GallBladder was so infected that he had to leave my encztions opened and let them drain the infection.He packed them with gauze sent me home same day two days later returned to office to get those removed and have taped till they close on there on.I have been on antiobiotics.I can say this is the sickest I have ever been.I would never want anyone to go thru what I had to go thru.Worse than any of the 2 children I have.Here it has been a week and I am still in pain.Doctors says its normal will last for 4 weeks.I will be fine.The doctors give me Tylenol like Tylenol is going to help my pain.Lay these doctors down see if they are given Tylenol after this surgery.All I can say is they put air in you during surgery and its hell after surgery with Backaches and tummy aches.
by Della1234, Nov 26, 2003 12:00AM
I just had Laproscoptic surgery I had my GallBladder removed on Tuesday Nov.18,2003 and I have been in so much pain.My GallBladder was so infected that he had to leave my encztions opened and let them drain the infection.He packed them with gauze sent me home same day two days later returned to office to get those removed and have taped till they close on there on.I have been on antiobiotics.I can say this is the sickest I have ever been.I would never want anyone to go thru what I had to go thru.Worse than any of the 2 children I have.Here it has been a week and I am still in pain.Doctors says its normal will last for 4 weeks.I will be fine.The doctors give me Tylenol like Tylenol is going to help my pain.Lay these doctors down see if they are given Tylenol after this surgery.All I can say is they put air in you during surgery and its hell after surgery with Backaches and tummy aches.
by Della1234