{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T06:17:02Z","timestamp":1789193822548,"version":"build-2803163510"},"reference-count":24,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,2,15]],"date-time":"2024-02-15T00:00:00Z","timestamp":1707955200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Low phospholipid associated cholelithiasis (LPAC) is associated with variants of the adenosine triphosphate\u2010binding cassette subfamily B, member 4 (ABCB4) gene and is characterized by reduced phosphatidylcholine secretion into bile, impairing the formation of micelles and thus exposing bile ducts to toxic bile acids and increasing cholesterol saturation. LPAC is present in 1% of patients with gallstones and post\u2010cholecystectomy pain is common in this group. LPAC is an under\u2010appreciated cause of post\u2010cholecystectomy pain. The aim of this study is to assess a cohort of patients with post\u2010cholecystectomy pain to identify those with clinical features suggesting that further investigations for LPAC would be beneficial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective chart review was performed of the first 2\u2009years of post\u2010operative follow\u2010up for all patients under 40\u2009years of age undergoing cholecystectomy for symptomatic gallstones at a tertiary centre between January 2016 and December 2017.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>258 patients under the age of 40 underwent a cholecystectomy. 50 patients (19.4%) reported abdominal pain post\u2010cholecystectomy. Five patients (1.9%) fulfilled the criteria for suspected LPAC. Family history of gallstones was documented in 33 of 258 (12.8%) of cases. Obstetric history was obtained in 69 of 197 (35%) female patients. None of the five patients identified above who satisfied the criteria of LPAC had the diagnosis of LPAC considered by their treating clinicians.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>LPAC is an under\u2010recognized cause of post\u2010cholecystectomy pain. Treatment can avoid long\u2010term symptoms and complications. Clinicians should take a family history and obstetric history to alert them to the diagnosis of LPAC.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.18904","type":"journal-article","created":{"date-parts":[[2024,2,16]],"date-time":"2024-02-16T05:34:05Z","timestamp":1708061645000},"page":"1102-1107","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Searching for low phospholipid associated cholelithiasis among patients with post\u2010cholecystectomy biliary pain"],"prefix":"10.1111","volume":"94","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9057-4988","authenticated-orcid":false,"given":"Andrew","family":"Trinh","sequence":"first","affiliation":[{"name":"Department of Medicine Royal Melbourne Hospital and The University of Melbourne  Parkville Victoria Australia"},{"name":"Department of Gastroenterology Royal Melbourne Hospital  Parkville Victoria Australia"},{"name":"Sir Peter MacCallum Department of Oncology The 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