title: Surgical therapy for biliary dyskinesia: a meta-analysis and review of the literature.
abstract: BACKGROUND
  Although biliary dyskinesia is treated commonly with cholecystectomy, the supporting literature is limited. A review and meta-analysis of the literature were performed to assess the efficacy of surgical therapy for biliary dyskinesia.
  
  
  METHODS
  A MEDLINE search for the period 1965 to 2003, using the search strings "biliary," "acalculous," "dyskinesia," "cholecystitis," "cholecystectomy," and "therapy" returned 187 articles. Inclusion criteria required a study design that placed patients with biliary dyskinesia into one of two treatment groups, cholecystectomy or nonoperative therapy, and a follow-up assessment of symptomatic improvement.
  
  
  RESULTS
  Five studies met the inclusion criteria, representing a total of 274 patients. Surgical therapy resulted in 98% symptomatic relief compared to 32% with nonoperative management (P<0.0001). Patients undergoing surgical therapy for biliary dyskinesia were 2.79 times more likely to have symptomatic relief versus nonoperative therapy (95% confidence interval, 2.05-3.79).
  
  
  CONCLUSIONS
  Based on this meta-analysis, cholecystectomy for biliary dyskinesia is an effective therapy and offers significant symptomatic relief over nonoperative therapy.
authors.affiliation: Department of Surgery, George Washington University Medical Center, Washington, DC 20037, USA.
authors.forename: Todd A
authors.initials: TA
authors.lastname: Ponsky
authors.forename: Robert
authors.initials: R
authors.lastname: DeSagun
authors.forename: Fredrick
authors.initials: F
authors.lastname: Brody
mesh_terms: D001657:Biliary Dyskinesia / Q000601:surgery* / Q000628:therapy; D002763:Cholecystectomy; D006801:Humans