Midwest Surgical AssociationLong-term efficacy of laparoscopic cholecystectomy for the treatment of biliary dyskinesia
Section snippets
Data source
The patient data were compiled using a retrospective chart review technique. All patients possessing this dataset were identified at a single institution, Rush University Medical Center, between 2001 and 2012. These dates were selected as the electronic medical record was initiated at our institution in 2000. The electronic medical record allowed for efficient identification and examination of patient charts.
Study subjects
Patients were identified and included on the basis of an International Classification
Results
A total of 67 patients met inclusion criteria as described in the “Methods” section. Of these patients, 34 (51%) were available for long-term follow-up via telephonic survey. The average time of survey was 65 (range: 6 to 134) months. Ninety-four percent (n = 32) of patients in this cohort were women. The average age was 41 (range: 18 to 73) years. The majority (n = 24) were Caucasian, at 70%. Five (15%) were Hispanic and 5 (15%) were African-American. All patients underwent a HIDA scan, with
Comments
The long-term success rate for the treatment of biliary dyskinesia with laparoscopic cholecystectomy at our institution was 88%. As demonstrated in Table 2, preoperative symptoms were similar for both groups, establishing a homogenous preoperative cohort. We did not find that a lower HIDA scan ejection fraction value correlated with success postoperatively, and this remains controversial in the literature.5 Those patients who did not respond to treatment were found to have a higher number of
Conclusion
This study demonstrates the durability of laparoscopic cholecystectomy over time for the treatment of biliary dyskinesia. Our data also reiterate the need for careful patient selection, as those with additional preoperative diagnostic studies were found to have decreased response rates to laparoscopic cholecystectomy. Further randomized controlled trials examining the long-term efficacy of laparoscopic cholecystectomy for the treatment of biliary dyskinesia, specifically with special attention
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Cited by (12)
Gallbladder and sphincter of Oddi disorders
2016, GastroenterologyCitation Excerpt :Cholecystectomy is considered when these methods fail, and symptoms are severe. The reported results of surgery vary widely.2,3,15 Many claim benefit in >80% of patients, but most studies are of poor quality with several potential biases; none have limited intervention to patients with negative EUS exams.
Prediction of symptom improvement in children with biliary dyskinesia
2015, Journal of Surgical ResearchCitation Excerpt :Our study also demonstrated pain improvement in over 80% of patients suggesting that most patients have some benefit from cholecystectomy even if they do not report complete resolution of symptoms. These results are consistent with previous pediatric studies noting postoperative symptom improvement in 79%–96% of patients [7–9,11–14] and adult studies reporting symptom improvement in >80% of patients on long-term follow-up [15]. From 2004–2010, the number of cholecystectomies performed for biliary dyskinesia rose by 63% [4].
Use of endoscopic gallbladder stenting and biliary scintigraphy for diagnosis of gallbladder dyskinesia: a case report
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The authors declare no conflicts of interest.