Evaluation of surgical outcomes and gallbladder characteristics in patients with biliary dyskinesia.
BACKGROUND
This study was designed to compare symptomatic outcomes following cholecystectomy in patients with biliary dyskinesia.


METHODS
From 1999 to 2006 at New York University Medical Center, 197 adults underwent hepatobiliary scintigraphy with cholecystokinin administration to evaluate gallbladder ejection fraction (GBEF). Biliary dyskinesia was demonstrated in 120 patients based on decreased GBEF of </=35%. Forty-four patients underwent cholecystectomy, and data from chart review and telephone questionnaires were available for 42 patients. Patients reported symptomatic improvement whether gallstones were present (25/27, 92.6%) or absent (13/15, 86.7%) prior to cholecystectomy (p = 0.90). The most common pathologic findings were chronic cholecystitis and cholesterolosis, regardless of the presence of gallstones. Additional data from 101 of the 120 patients with decreased GBEF demonstrated 74/101 (73.2%) patients were diagnosed with gastroesophageal reflux disease (GERD), and 59/101 (58.4%) patients were diagnosed with gastritis.


RESULTS
The results of this study suggest that biliary dyskinesia should be considered as part of the spectrum of symptomatic gallbladder disease that can be successfully treated with cholecystectomy and that biliary dyskinesia is associated with GERD and gastritis.
Department of Surgery, New York University School of Medicine, New York, NY, USA.
M Shirin
MS
Sabbaghian
Barrie S
BS
Rich
Gary D
GD
Rothberger
Jonathan
J
Cohen
Steven
S
Batash
Elissa
E
Kramer
H Leon
HL
Pachter
Stuart G
SG
Marcus
Peter
P
Shamamian
D000328:Adult; D001657:Biliary Dyskinesia / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D049448:Cholangiopancreatography, Magnetic Resonance; D002763:Cholecystectomy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005704:Gallbladder / Q000503:physiopathology* / Q000601:surgery; D016473:Gallbladder Emptying / Q000502:physiology*; D006801:Humans; D008297:Male; D011184:Postoperative Period; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome