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Conditions and Diseases > Bile Duct Disorders Forum > Post biliary sphincterotomy and stent placement pain
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Q: Post biliary sphincterotomy and stent placement pain
asked by: nadmonk on June 12th, 2009
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My wife started experiencing severe pain associated with her biliary system in mid February. An ultrasound revealed dilation in the CBD (about 1.5 cm) as did the MRI. An ERCP and hydoscan showed that the cystic duct wasn't taking up bile. She was admitted and the first doctor recommended removing the gallbladder. We went to a major university hospital for a second opinion.

That doctor recommended a percutaneous cholecystectomy tube to drain the gallbladder. There was abnormally high levels of pain from the tube after placement for about 1.5 weeks, but after that subsided she was ok for about 3-5 days, at which point the GB pain came back, although not as severely as before. The tube needed to stay in for a total of 7 weeks, as after 2 the wound channel had not sufficiently healed. After the tube was removed, her GB pain went back to its previous highs. They did notice that the CBD didn't seem to be draining.
The first doctor we saw removed the GB. He did find thickening of the walls and some erosion. That seemed to relieve her symptoms for about 1 week.

The symptoms did return, although not at the original highs. The GI doctor recommended a sphincterotomy to aid in draining of the CBD.
Another GI doctor did the ERCP. After performing the sphincterotomy, the CBD wasn't draining as quickly as he liked, so he also placed a stent. The stent is to be removed in 3 months.
When the stent was placed he could see the CBD draining quickly. This was on May 27th.

My wife was sent home about 1 hour after the procedure was finished. In addition to the normal gas pain, she began experiencing a twisting, stabbing pain in the center of her abdomen behind her rib cage. She said it felt like it was coming from her stomach and it felt like it was doing flips. The intense pain would come frequently and would typically last for anywhere between 5-15 seconds. It can be intense enough it could bring her down to her knees. In addition to that pain, she also feels as though she's been punched in the stomach. This is definitely different that the pain that she had been experiencing prior to this.

The night after the ERCP (May 28th), we went to the ER. They checked her blood levels, and aside from borderline lipase, were normal. On May 29th, after speaking with the doctor that performed the ERCP, he scheduled an emergency CT. The CT didn't show any pancreatic inflammation. He said the CBD's dilation had gone to 6 mm (from a max of 1.6 cm).
While the twisting/stabbing pain aren't as frequent as they were the two days after the procedure they still come just as intensely. They don't seem to correspond with eating or not eating. They come whether she is laying down or standing, although a trip to the store last night (June 11th), brought them on much more frequently. So even though they come when laying down (in the neighborhood of 10-20 per day), being up and active brought about 15-20 in a 1 hour period.

On the chance this was caused by a muscle spasm, her original GI doctor prescribed dicyclomine (10 mg, 3 x daily). The first day there were less, but that may just be coincidence as it doesn't seem to be affecting them now. She still has the "punched in the stomach soreness" as well.

Her doctor says he hasn't seen/heard of anything specifically like this (been a GI doctor for ~30 years). The doctor that performed the ERCP just referred us to the original GI doctor.

She's scared as we don't know what this is or what is causing it. Is this typical following an ERCP, sphincterotomy, and stent placement? Will the symptoms go away on their own? Will they go away when the stent is removed? Any insight into this would be greatly appreciated, we haven't been able to find much information about this.
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Vivvers
replied on August 5th, 2009
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I have read many health forums but have never responded. I had to respond to this one tho..I too have the same exact pain/symptoms your wife has. I am in my early 40's, have had 8 ERCP's, too many stents to count, gallbladder removed, several hospital stays due to elevated enzyme levels (but never very elevated) and pain, pain , pain. I have been to a major university medical center (was there last week) and maybe someday we'll figure this out. In the meantime, I wish your wife the best and if you get a confirmed dx and/or treatment plan, I would love to hear about it! She is not alone.
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MICHELRAF8
replied on September 2nd, 2009
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13 ERCPS
I am 36 yrs old and have also had my gallbladder removed and tomorrow will be my 13th ercp! 6 months ago i had a stent put in and experienced the same pain, i was sent to a different dr at dartmouth in nh 1 month later and they took the stent out,i'm not sure why or how or anything as to why this happends. i believe that my dr will put the stent back in tomorrow and if it happends again i will be back on , but in the mean time if anyone has answers please let us know!
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scarlett2ts
replied on September 5th, 2009
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Common bile duct stent pain
I had my gallbladder removed 4-08,..2 days after liver enzymes sky high,..pain,...more severe than GB pain. Today I have had 3 ERCPS which included 2 sphincterectomies on the first 2 and stent placement on the 3rd which was almost 3 weeks ago. I have been pain free up until about 1 week ago. Sharp stabbing pain but only for less than 5 minutes,...this morning...I have had 2 episodes and had to take 3 levsin. Was told bile duct could not spasm with a stent,...is this true?...any advise would be appriciate...
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dummies
replied on September 17th, 2009
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proublems after gallbladder removed alot of pain
i see there are many like us out there i had mine out gallbladder july 12 2006 have pain all the time lay in bed cry no insurince husband got laid off all they wanted to do is ct scans went to different hospitals said theirs was better been to several emergency rooms when i had insurence was treated like crap wanted to know if i could be pregnant said no husband had vicetamie did i cheat on him i said no i did not same place asks did i come to er just to get drugs isaid no im sick as a dam dog there are days i cant do nothing in pain everything wears me out i just try to deal with it my own way no one listens any way i can tell when i fill real bad i pee in a container let set within a half hour urin will turn dark like coke with white cystals in it laying in bottom have took to doctors theyblow me off i say im done throwing money away thanks sheila c
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Vivvers
replied on September 17th, 2009
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Hello again! Unfortunately, there are others like me out there. Sorry for your luck. Smile I have decided to bite the bullet and go for surgery. I am too young to be hurting like this and I take too darn many pain killers. I just want to go about my day not wondering if I have pain meds close by. Hate going to the ER where they look at you like a drug seeker. I will be having a Transduodenal Sphincteroplasty the first week of November. I was referred to a surgeon that I like and trust (I have checked him out too) and my husband and I figure why not at this point. Hope you all are feeling better soon. I'll keep you posted.
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