[The causes of the so-called post-cholecystectomy syndrome and the possibilities of its timely recognition].

A simple scheme for the examination of patients for identifying the causes of the so-called postcholecystectomy syndrome (PCES) is suggested from experience in the examination of 1,712 patients with this syndrome. Three groups of patients are distinguished. First group--individuals with an external biliary fistula. Second group--patients with jaundice or with signs of jaundice suffered in the past after an operation. Third group--patients with abdominal pain and dyspeptic disorders after removal of the gallbladder but without an external biliary fistula and jaundice. The author gives a clinical evaluation and recommendations for using in establishing the diagnosis ultrasonic examination, cholefistulography, intravenous cholegraphy, percutaneous transhepatic cholangiography, retrograde cholangiopancreaticography, and computerized tomography conformably to the distinguished groups. After the examination was completed, the need for a repeated operation or active treatment (endoscopic papillotomy, removal of stones through the fistula) occurred in 98.7% of patients of the first group, in 73.8% of those in the second group, and in 15.7% of patients of the third group.