Can symptoms continue after gallstones are removed?
Removal of the gallbladder (cholecystectomy) should eliminate all gallstone-related symptoms except in three situations: • gallstones were left in the ducts, • there were problems with the bile ducts in addition to gallstones, and • the gallstones were and are not the cause of the symptoms. The possibility of gallstones in the ducts can be pursued with MRCP, endoscopic ultrasound, and ERCP. There is only one problem with the ducts that can cause gallstone-like symptoms, and that is a rare condition called sphincter of Oddi dysfunction, discussed below. The common bile duct has a muscular wall. The last several centimeters of the common bile duct’s muscle immediately before the duct joins the duodenum comprise the sphincter of Oddi. The sphincter of Oddi controls the flow of bile. Since the pancreatic duct usually joins the common bile duct shortly before it enters the duodenum, the sphincter also controls the flow of fluid from the pancreatic duct. When the muscle of the sphincter tigh
