• Pain recurring after cholecystectomy has occasionally been caused by stones that had been overlooked, by other residual conditions in the biliary tract, and by lesions in the duodenum or pancreas; it may also be caused by more remote abdominal or even retroperitoneal lesions. The diagnosis is especially difficult in the absence of jaundice. Cholangiograms after injection of sodium iodipamide are helpful in proving or disproving the patency of the extrahepatic bile passages and can be made at operation. In some cases of dysfunction of the sphincter of Oddi, sphincterotomy gives relief; in others, when there is evidence of inflammation in the head of the pancreas, choledochoduodenostomy is called for. When both operations fail, relief has been obtained by blocking or resecting the splanchnic nerves. In one case in which the abdomen, and especially the biliary tract, had been carefully explored and every effort had been made to attack the problem directly, a cervical chordotomy gave complete relief.
Walters W. POSTCHOLECYSTECTOMY DYSKINESIA: WITH PANCREATITIS, SPHINCTERITIS, AND CHOLEDOCHOLITHIASIS AS CAUSES. JAMA. 1956;160(6):425–431. doi:10.1001/jama.1956.02960410001001
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