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"RE-FORMED GALL BLADDER" WITH STONES FOLLOWING CHOLECYSTECTOMY SEVENTEEN YEARS AGO

HAROLD J. LIVINGSTON, M.D.; SAUL F. LIVINGSTON, M.D.
AMA Arch Intern Med. 1952;89(6):961-966. doi:10.1001/archinte.1952.00240060104012.
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THE REAPPEARANCE of abdominal symptoms following cholecystectomy frequently provides a source of distress to both the patient and the physician. Dependent upon the lapse of time between the surgical procedure and the onset of symptoms, various diagnoses, such as postcholecystectomy syndrome, spasm of or stones in the common duct, stricture or angulation of the extrahepatic ducts, chronic hepatitis, chronic pancreatitis, and neurogenic factors, are lightly proffered without adequate substantiation, and usually symptomatic therapy is instituted. While these may represent the disorders following gall-bladder surgery, other factors not commonly apparent to the physician at the time may play an integral part in the redevelopment of the symptom complex. A careful history and physical examination augmented by a detailed description of the surgical procedure and findings at the time of the operation will often lead to a clearer understanding of the underlying pathological changes. The proper assessment of the many potential alterations

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