Midwest Surgical Association
Long-term efficacy of laparoscopic cholecystectomy for the treatment of biliary dyskinesia

https://doi.org/10.1016/j.amjsurg.2013.09.012Get rights and content

Abstract

Background

Laparoscopic cholecystectomy is the treatment of choice for biliary dyskinesia; however, long-term outcomes remain unclear.

Methods

A retrospective review of patients diagnosed with biliary dyskinesia and treated with laparoscopic cholecystectomy at a single institution between 2001 and 2012 was conducted. Long-term outcome data were obtained by telephonic interview using a modified Likert scale.

Results

Sixty-seven patients met inclusion criteria, of which 34 patients (51%) had long-term follow-up data. Mean time of follow-up was 65 (range: 6 to 134) months. Long-term follow-up demonstrated symptom response in 88% (n = 30) of patients (responders), compared to no response in 12% (n = 4) of patients (nonresponders). Responders underwent a mean of 1.56 preoperative diagnostic procedures, compared to 2.5 for nonresponders (P = .01).

Conclusion

This represents the longest mean time of follow-up study demonstrating the success of laparoscopic cholecystectomy to improve symptoms in patients with 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

References (8)

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The authors declare no conflicts of interest.

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