Results of surgical therapy for biliary dyskinesia.
One hundred eighty-seven patients who presented with symptoms consistent with biliary colic but had no ultrasonic evidence of cholelithiasis were observed in an effort to identify those with a functional gallbladder disorder that might benefit from surgical intervention. All patients underwent quantitative evaluation of gallbladder emptying using cholecystokinin biliary scanning, and ejection fractions less than 35% were considered abnormal. One hundred twenty-nine patients (69%) had abnormal ejection fractions, and 88 (68%) of these subsequently underwent cholecystectomy. Sixty of the surgical specimens revealed pathologic changes. Eighty-four percent of patients successfully contacted for follow-up experienced complete relief, and another 13% had partial relief of preoperative symptoms. Only two patients reported no change in symptom complex. Twenty-nine patients with abnormal ejection fractions elected not to undergo surgery. Fifty-nine percent of these patients continued to experience symptoms of biliary colic at a mean follow-up of 22 months. Of the 44 patients with normal ejection fractions, 35 (80%) reported resolution of symptoms during follow-up of medical treatment. Cholecystokinin biliary scanning can help identify patients with acalculous, functional gallbladder disease who may benefit from cholecystectomy.
Misra
D C
DC
Department of Surgery, William Beaumont Hospital, Royal Oak, Mich. 48073.
Blossom
G B
GB
Fink-Bennett
D
D
Glover
J L
JL
D000328:Adult; D001657:Biliary Dyskinesia / Q000000981:diagnostic imaging / Q000601:surgery*; D002763:Cholecystectomy; D002764:Cholecystitis / Q000601:surgery; D002766:Cholecystokinin; D002769:Cholelithiasis / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D005704:Gallbladder / Q000000981:diagnostic imaging; D005705:Gallbladder Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007098:Imino Acids; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds; D011446:Prospective Studies; D011877:Radionuclide Imaging; D019785:Technetium Tc 99m Disofenin
D007098:Imino Acids; D015609:Organotechnetium Compounds; D002766:Cholecystokinin; D019785:Technetium Tc 99m Disofenin