Laparoscopic cholecystectomy: effective treatment for chronic abdominal pain in children with acalculous biliary pain.
OBJECTIVE
Acalcular biliary pain is a term used to identify patients who have significant abdominal pain related to an abnormally low gallbladder ejection fraction in the absence of cholelithiasis. Little is known about this disease in the pediatric population. The aim of this study was to determine whether laparoscopic cholecystectomy is an effective method for treatment of children with abdominal pain in the setting of acalcular biliary pain and whether one can predict the outcome preoperatively.


METHODS
The charts of all children who underwent laparoscopic cholecystectomy for acalcular biliary pain in our institution from January 1991 through April 1998 were reviewed. Sixty-three patients were identified as children with acalcular biliary pain who underwent laparoscopic cholecystectomy. Forty-eight patients were contacted successfully and they all completed the questionnaire. Complete resolution of abdominal pain occurred in 72%, and another 18% had near-complete resolution of pain. Some improvement was noted by 8%, and only 2% had no improvement. In a multiple logistic model, none of the variables were significant predictors of response outcome.


CONCLUSIONS
Laparoscopic cholecystectomy is an effective means of therapy for children with abdominal pain and low gallbladder ejection fraction. It is difficult to predict patients with complete response based on the preoperative clinical findings.
Michail
S
S
Department of Pediatrics at Wright State University and The Children's Medical Center in Dayton, OH 45458, USA.
Preud'Homme
D
D
Christian
J
J
Nanagas
V
V
Goodwin
C
C
Hitch
D
D
Mezoff
A
A
D015746:Abdominal Pain / Q000175:diagnosis / Q000601:surgery*; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D005705:Gallbladder Diseases / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D010147:Pain Measurement; D011237:Predictive Value of Tests; D011300:Preoperative Care; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016896:Treatment Outcome