I have biloma, stomach pain and hard stools post gallbladder removal. Is this due to bile leakage?

Question

Hello doctor,

Before two months, I had my gallbladder removed. Two months after, I had a 9 mm stone lodged. However, this did not resolve the issue. One week ago, they found a biloma however, my surgeon does not think it is a issue though I am experiencing stomach pain and lake stools. His conclusion is post op complications. I do not believe this and he refuses to do a Hida test to check for a bile leak. Please help.

Answer 1

Hello,

Welcome to icliniq.com.

Well, your surgeon seems to be doing the right things. There are several other reasons to think the alternative diagnosis like peptic ulcer disease, biliary reflux, post cholecystectomy pain, or functional abdominal pain. The factors which predispose you to develop above things and not the biliary leak are your weight, anxiety, recent admission into hospital due to surgery, and follow up admission after MRCP (magnetic resonance cholangiopancreatography), use of painkillers and antibiotics (maybe on your last admission), and all over the background of normal follow up MRCP which you have recently.

It is common to have pain after cholecystectomy, and there are various reasons behind it namely, the bile pool in the small duodenum with excessive gas and bloating after meals and some bile reflux in the stomach causing biliary gastritis. The surgical clips in fact can cause some pain and some spasm of the remaining bile ducts.

If you could further elaborate to me the following findings, I may be able to tell the exact reason of your pain out of above possibilities. Like exact location of the pain? Does it go to back, over the right lower chest? When does this pain come? After meals? If so, how long after meals? Whether it comes within seconds, or minutes or half an hour after? Is this a spasm? Or piercing needle type of pain? Have you noticed acidity or reflux nowadays?And any change in bowel habits? Have you used Tylenol and opioid analgesics? How frequently? And did they improve your pain? Let me know the above, and I can provide you guidance regarding its management.