Vagotomy in the treatment of biliary dyskinesia.

Abstract

POSTCHOLECYSTECTOMY colic, or biliary dyskinesia, is a poorly defined syndrome which tends to occur in nervous and hypersensitive persons and which can be diagnosed only by the exclusion of organic disease. The cause of the dyskinesia has not been established, but it is supposed by some that spasm of the sphincter of Oddi plays a part in the production of the symptoms. 1 Biliary dyskinesia may cause symptoms indistinguishable from biliary colic due to a calculus. The patient complains of intermittent attacks of colicky pain in the right upper quadrant and epigastrium which may radiate to the scapula and to the right shoulder. Nausea and vomiting frequently are associated with the attacks. Chills, fever and jaundice do not ordinarily occur. The possibility of somatic pain as well as stone in the stump of the cystic duct, stone in the common duct, and disease of adjoining viscera (such as duodenal ulcer,