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Abstract
Background: Biliary reflux secondary to cholecystectomy or endoscopic sphincterotomy (ES) is a late condition commonly encountered among patients referred for gastroenterological management. It has been recognized as part of the post-cholecystectomy syndrome, but it also occurs long time after endoscopic biliary clearance through endoscopic retrograde cholangiopancreatography (ERCP). Dysgeusia may be a leading symptom in patients with biliary reflux. Materials and methods: Our study aimed at assessing the presence of dysgeusia among patients with biliary reflux secondary to either cholecystectomy or ERCP and ES, comparatively with a group of control patients diagnosed with non-alcoholic fatty liver disease (NAFLD). 47 patients were included in the study over 6 months: 14 patients diagnosed with post-cholecystectomy syndrome, 16 patients evaluated 1 year after ERCP and ES and 17 controls diagnosed with NAFLD. Presence of dysgeusia was determined by an open questionnaire. Results and discussion: Statistically significant differences were observed among the study groups and controls. Dysgeusia was a condition more frequently encountered in both study groups, compared to NAFLD patients. Nevertheless, there are no significant differences between the two study groups as to the presence of such symptom. Conclusions: Dysgeusia may be regarded as a common symptom associated with biliary reflux, so that it may be considered a potential late complication of ERCP and cholecystectomy.
Keywords: endoscopic retrograde cholangiopancreatography, post-cholecystectomy syndrome, biliary reflux, medical complications.
1. BACKGROUND AND AIMS
Dysgeusia has traditionally been regarded to as an acquired alteration in the sense of taste. Taste itself is a sensory capacity depending mainly on the discriminative sensing function for flavor, itself dependent on the two main independent sensory systems, that of smell and touch [1]. Alteration of lingual papillary capacity to detect taste alongside with smell impairment may lead to dysgeusia. Such sensory impairment may occur secondary to an oro-pharyngeal bile reflux, involving a mechanism similar to that of acid reflux and mechanically trigered inflamation, which has been described secondary to the gastroesophageal reflux disease [2,3]. Bile reflux may be determined either by functional biliary dyspepsia or secondary to endoscopic retrograde cholangiopancreatography (ERCP) and subsequent biliary sphincterotomy or cholecystectomy involving continuous biliary duodenal clearance. ERCP is a complex endoscopic procedure useful in the diagnosis and management of bile duct diseases, involving endoluminal sphincterotomy of the duodenal papilla leading...