SUMMARY Thirty to 40 per cent of patients have symptoms after cholecystectomy (postcholecystectomy syndrome (PCS)). Organic aetiology can be found in about 50 per cent. Common duct stones and papillary stenosis are the most frequent organic biliary causes. They can be prevented by appropriate peroperative tests. Re-operation should be considered only after conservative methods of treatment have failed or wherever the causative pathology cannot be otherwise treated. Oesophagitis, ulcer, pancreatitis and liver disease are the commonest organic extrabiliary causes of PCS. These complications can arise because of incomplete preoperative diagnosis. Liver and pancreatic damage may also result from previous biliary tract disease. They can be prevented by early cholecystectomy. In the remaining 50 per cent of PCS no organic disease can be found. Metabolic changes after cholecystectomy do not seem to account for PCS. The significance of functional biliary disorders is not yet clear. The irritable colon is the most frequent of the non-organic extrabiliary disorders.