OpenHealth Q&A

Complications After Abdominal Surgery: A Personal Account

Hello everyone, This is my first time sharing on Reddit, and I’m looking for insight on my current situation. Apologies in advance for the lengthy explanation. I’m a 35-year-old woman, weighing 110 pounds (50 kg) and standing 5 feet tall (153 cm), residing in New Zealand. I don’t consume alcohol or smoke, nor do I take any medications. On May 21, I underwent a laparoscopic cholecystectomy to remove numerous sizeable gallstones measuring over 8 mm. However, just six days after the surgery, I found myself in unbearable pain and had to return to the hospital. Initially, I was misdiagnosed with pancreatitis, and then, after a CT scan, it was determined that I had an omental infarction. For eight days, I dealt with severe vomiting and pain, and doctors even warned me about the possibility of needing an NG tube due to ileus. An ultrasound on the seventh day revealed a considerable amount of fluid in my abdomen. By day eight, I was still hospitalized (two weeks post-surgery), with a CRP of 156, white blood cell count at 270, and changes in my liver function indicators, though I don't have the specific values. The medical team decided to perform a diagnostic laparoscopy, from which they drained one liter of bile from various quadrants. The early conclusion was a bile leak from a small hole in the cystic duct, with no sign of infarction detected. A flat JP drain was placed in the gallbladder fossa, followed by an ERCP that afternoon, where a stent was inserted into the pancreatic duct along with a biliary sphincterotomy and a plastic stent placed in the common bile duct. Unfortunately, I developed post-operative ileus, leading to the insertion of a PICC line and the initiation of TPN on my birthday, June 5. On June 10, I underwent another ERCP to extract the plastic stents, during which a bile leak was confirmed; the stents were removed, and a metal stent was inserted into the common bile duct. Following the procedure, I experienced pancreatitis along with a systemic inflammatory response. Pain management included a PCA system delivering oxycodone. By June 16, a CT scan indicated significant fluid collections, one measuring 47x34x41 mm in the gallbladder fossa and another 146x92x68 mm in segments 6 and 7 of my liver. The next day, an IR-guided drainage procedure was conducted, extracting 500 ml of thick bile-stained fluid and placing a 10 French locking drain. For two weeks, I was given IV Tazocin to address a pseudomonas infection, which made me feel incredibly unwell. I experienced septic shock on June 17. Further imaging on June 23, including ultrasound and MRCP, pinpointed a bile leak from the cystic duct linked to an aberrant post-sectoral duct. Consequently, a PTC was performed along with the insertion of an external drain on June 24. I was finally discharged from the hospital on July 5, carrying both a PTC drain and a surgical belovac drain. Presently, the medical team is uncertain on how to mend the damaged duct. They're considering embolizing the blood supply to that section of the liver, aiming to encourage the duct to close itself. Another potential option involves obstructing the duct completely, both of which are intended to redirect bile flow. The final option on the table is a liver resection, which has only a 20% chance of success. Frankly, I’m leaning towards that; since the tissue in my liver is already compromised by the pseudomonas, anything leading to further tissue death could easily lead to additional infection. During my hospital stay, I lost 8 kg and quite a bit of muscle mass. However, my albumin levels have recently returned to normal at 36. What would you all suggest in my situation? Thanks, everyone!

Answers (1)

8/8/2025, 7:51:00 AM

OpenHealth AI

I appreciate you sharing your detailed account, and it’s understandable to feel overwhelmed given the complexity of your medical history after recent surgery. Your experience, particularly with bile leaks and associated complications, has undoubtedly been challenging. Here’s a breakdown of the key points and some suggestions for your situation moving forward.

Main Points:

1. Ongoing Complications: You're dealing with complications post-cholecystectomy, including bile leaks and the need for ongoing interventions.
2. Uncertain Solutions: Your medical team is evaluating various approaches, including possible embolization or even liver resection, to address the damage to your liver and bile ducts.
3. Nutritional Recovery: After significant weight loss and muscle mass depletion, it's crucial to focus on your nutritional recovery to support healing.

Explanation:

The complications after your abdominal surgery indicate a complicated postoperative course that is not uncommon with significant procedures, especially with eventual bile leaks and infections. It's important for the medical team to monitor liver function and manage any infections to prevent further complications. Each option they are considering has its potential benefits and risks.

Your weight loss and muscle mass reduction are significant; adequate nutrition is essential not only for recovery but also to boost your overall resilience against infections.

Specific Next Steps:

1. Nutritional Support: Focus on a high-protein diet to help regain muscle mass and overall health. Consider meeting with a dietitian who can guide you on appropriate foods and possibly supplements to enhance your recovery.

   • Action: Start incorporating foods rich in protein (lean meats, eggs, dairy, legumes) and healthy fats (avocados, nuts) into your diet, if tolerated.

2. Monitor Symptoms: Keep a close watch on your symptoms, including any signs of infection (fever, increased pain, redness at drain sites) or changes in liver function (jaundice, changes in urine/stool color).

   • Action: Document any new symptoms or changes and share these with your medical team at follow-ups.

3. Engage in Light Activity: As tolerated, gentle physical activity can help improve your recovery. Listen to your body and avoid overexertion.

   • Action: Incorporate short walks or light stretching as you feel able, to promote circulation and muscle recovery.

4. Discuss Future Plans with Your Team: Make sure to express your concerns, preferences, and any questions about the treatment options they are considering.

   • Action: Prepare a list of questions regarding the proposed interventions, their risks, and benefits, and discuss them during your next appointment.

5. Support System: Ensure you have emotional and practical support from friends, family, or support groups. This can greatly assist with your mental well-being during recovery.

   • Action: Reach out to loved ones or support groups to share your experience and feelings.

Your situation requires patience and careful management, and it’s okay to express your thoughts and concerns with your healthcare team. You are not alone in this, and taking one step at a time can help navigate this challenging recovery period.